Transcript Document
Cost Savings and Avoiding Wastage A Medication Journey Patients Own Drugs (PODs) • POD letters • Use green POD bags • All staff should be POD trained • Use PODs whenever suitable • One stop dispensing whenever possible Drug Budgets 2010/2011 Budget £4.54 million Spend £4.98 million 2011/2012 Budget £5.10 million Spend £5.69 million (Large increase includes budget for Hampshire CAMHS) Medication Journey How can we help? • Use PODs, ask for them to be brought in. • One Stop if appropriate. • Transfer all named items with the patient if they move ward, except CDs. • On discharge make sure all currently prescribed items are given to patient. • What are the most likely items to be missed? Items which get overlooked Remember it’s not just the cost but the inconvenience to patient/GP/ward •Examples of items often forgotten: • Inhalers: e.g Seretide ‘250’ ; Spiriva Handihaler • Eye drops: branded packs e.g Lumigan & Xalatan • Fridge items: prefilled insulin pens Lantus • Topicals: Dovobet Ointment Small study on OPMH ward Findings after 3 months from just 7 patients who were discharged. • £300.00 TTOs ordered when one stop medication already on ward. • £12.55 was the actual cost of medication which did need to be ordered to complete the TTO • £880.00 wasted medication which should have gone home with the patient. Pilot study 2011 OPMH 12 bed ward 6 month study evaluated the cost effectiveness of clinical screening by pharmacist prior to discharge summaries being sent to pharmacy. • May 2011 £1305 • June 2011 £1654 • July 2011 £1373 • Aug 2011 £706 • Sep 2011 £1002 • Oct 2011 £978 • Nov 2011 £994 • Dec 2011 £1612 Ave. spend before pilot £1444 Ave. spend after pilot £ 1058 Ave. saving/month £386 Tips for cutting down costs I • Avoid liquids and orodispersible preps. unless essential. Review regularly and before discharge. •Many patients say they cannot swallow tablets but simple techniques can be used to teach and re-assure a patient that they will not choke. •Make use of the Trust guidelines “swallowing pills” Tips for cutting down costs II • Assess need for food supplements regularly • If patient is on “One stop” do not order leave/discharge medication without checking the trolley first • Ask for PODs to be brought in if not available on admission •Transfer all medications if a patient moves ward. Cost effective prescribing tips for Doctors I • Quetiapine IR tabs have come off patent, use instead of XL preparations. • Venlafaxine XL tablets cheaper than XL capsules • The supply of newly started medications should be transferred to the patient’s GP to continue where possible (exceptions include clozapine). • Do not prescribe physical drugs or feeds in the community. Produced for each specialty by Ray Lyon, Chief Pharmacist. Cost effective prescribing tips for Doctors II •Do not use the term “Velotabs” if prescribing orodisperible tablets in the community as this is a brand name and Zyprexa will be dispensed. •Review need for higher dose long-acting injections this could save up to £817 per annum. •Pregabalin should be prescribed as BD rather than TDS as same price irrespective of strength. •Prescribe ADHD medication which is available in UK Concerta XL 54mg = £73.62 (2x27mg) Concerta XR 54mg > £600 (imported) Cost savings Remember everybody can help… “your Trust needs you”!!