Antibiotic cost savings from formulary restrictions and physician monitoring in a medical-school-affiliated hospital

Combined savings from restricted antibiotics $2.61 per antibiotic day and $34,597 after formulary restrictions. 7.2% and 12.4% savings respectively from the pharmacy’s 1985 $18.45 average cost per antibiotic day and $199,003 average monthly expenditure. No significant changes in LOS or mortality for patients after restrictions.

Reference:
Woodward RS, Medoff G, Smith MD, Gray JL. Antibiotic Cost Savings from Formulary Restrictions and Physician Monitoring in a Medical-School-Affiliated Hospital. American Journal of Medicine, 1987 (83):817-823

Setting:
1,208-bed, tertiary-care teaching hospital, St. Louis, MO, USA

Key staff:
infectious disease physician

Resources Required:
76 hours per month for pharmacist, 24 hours per month for ID fellows, 10 hours per month for 4 faculty

Intervention:
Restriction-creation of formulary restrictions for vancomycin and select aminoglycocides and cephalosporins, which would require obtaining ID approval for use. ID told not to reject requests but to use persuasion.

Impact:
Combined savings from restricted antibiotics $2.61 per antibiotic day and $34,597 after formulary restrictions. 7.2% and 12.4% savings respectively from the pharmacy’s 1985 $18.45 average cost per antibiotic day and $199,003 average monthly expenditure. No significant changes in LOS or mortality for patients after restrictions.