So why work so hard to manage drug costs? Why not just use anything that comes to market or put everything on your formulary? The most important reason is patient safety. How can the pharmacists, nurses, doctors, and therapists keep track of EVERYTHING for every drug? It is just not feasible to track the proper dosage, dosage adjustments, side effects, administration technique, etc, for every drug. When the formulary has one or two drugs per class, there is less opportunity for error.
Another argument about drug cost management boils down to this: do you believe that there are unlimited or limited resources available for healthcare? At some point, there are limitations on resources. As such, the pharmacy needs to be the best stewards of drug costs that it can be. Besides, in practice, who else is going to do it? The physician? The nurse? The truth is that managing the drug costs is the responsibility of the pharmacy despite the fact that the pharmacy does not have 100% control over those costs. As a wise pharmacist once said, “We can influence drug costs…not control them.”
So what can you do as an everyday pharmacist to influence drug costs? Plenty. Here are a few ideas:
- Therapeutic Interchange: Are therapeutic substitutions available that are less costly? If so, are you consistently making the interchange?
- If your department doesn’t have an important interchange, do you take the time to contribute an idea? Can you help by delivering some of the necessary information to create a compelling P&T review?
- Physician conversation: Making that call to the doctor takes some time…and some guts. Sometimes it’s tough to deal with a busy (and grouchy) physician who doesn’t want to be bothered…but you have to do it. The patients and the hospital depend on you to help make rational drug therapy recommendations.
- Are you making a smart decision on every drug order you send to the wholesaler? The larger wholesalers all have a feature of their ordering systems that allow you to check if a generic (or cheaper generic) drug is available for the item you are ordering. It usually also screens for contract compliance. Instead of assuming that the sticker you pulled off the last product is what you should buy this time, take a moment and double check.