Better control of blood cell drugs can save hospitals big money

Curbing the use of drugs that stimulate blood cell production can significantly reduce costs at the hospital level, Anesthesiology News reported.

The goal in using of erythropoietin-stimulating agents (ESAs) is to "provide the lowest dose possible that avoids transfusions," Jeff Hurren, a clinical specialist of drug information and policy at St. John Hospital and Medical Center in Detroit, told Anesthesiology News. But by doing so, hospitals can also save thousands or even tens of thousands of dollars a month.

In St. John's case, it switched ESA drugs from erythropoietin to darbepoetin, and delayed administration of any doses until seven days after admission for patients who could accept blood transfusions. In some cases, this meant that the administration of the drug occurred after the patients were discharged to outpatient care.

St. John not only reduced the possibility that some patients received double doses of ESA through medication errors, but was also able to cut costs by $16,000 a month. Banner Health, the Arizona-based hospital system, was able to save about $19,000 over two months by implementing similar guidelines.

Reducing healthcare costs by promoting more fiscally conservative use of prescription drugs in the hospital setting has been gaining prominence in recent years. The use of brand-name drugs over generics, for example, costs the Medicare program about $2.9 billion a year. Edmund Pezalla, M.D., Aetna's national medical director for pharmacy policy and strategy, has recommended that accountable care organizations take pharmaceutical utilization into account as a cost generator and find ways to better control it.

Moreover, Anesthesiology News noted, the overuse of the ESA darbepoetin by patients with chronic kidney disease or diabetes was associated with a higher risk of stroke--a condition that can cost a hospital hundreds of thousands of dollars to treat.

To learn more:
- read the Anesthesiology News article