Budget savings following a rationalisation of practice: a comparison of drug-prescribing costs in two different intensive care units

Aim

To ascertain whether a comparison of drug budget spending, in comparable ICUs, could lead to a rationalisation of clinical practice and budget savings.

Method

Two similar ICUs were chosen, both with the same bed numbers, similar patient groups, severity of admission (using APACHE II scores) and length of stay. The pharmacy departments cross-referenced the financial costs of all medications and sundries used in both ICUs. Where any major financial differences became apparent, the clinical practice related to these costs was investigated.

Results

This budget analysis highlighted several variations in clinical practice. The main differences found were in sedation practices, the use of neuromuscular blocking drugs, antimicrobial prescribing practices and the use of differing haemofiltration sundries. The standardisation of practice in these areas led to a financial saving of over £30,000 in a year between the two units, from a combined drug budget of approximately £300,000.

Discussion

This analysis facilitated discussion among the multidisciplinary intensive care team in an effort to improve patient care and save money at the same time. By analysing drug-prescribing costs and comparing clinical practices, we have shown that significant savings can be made. We were able to rationalise clinical practice without any significant changes in current management strategies.

Further differences in practice were also demonstrated by this study. It is hoped that, following discussions with all concerned individuals, further standardisations in practice and subsequent cost savings can be made.