Impact of the implementation of vasoactive drug protocols on costs in the treatment of critically ill patients.

Objective: To evaluate the efficiency of the protocolization and centralization of  the preparation of intravenous vasoactive drug mixtures in the treatment of  critically ill patients.

Method: A prospective interventional study (July 2012-December 2014) was  conducted to measure the impact of different vasoactive drug protocols on costs  in the treatment of critically ill patients. The economic impact was measured by  comparing the direct costs (fixed and variable) of the preparation of intravenous  vasoactive drug mixtures in the Pharmacy Department with their traditional  preparation in hospital care units. The variables time and cost of preparation of  an intravenous mixture were measured. Costs included pharmaceutical product,  diluent, medical supplies, cost of manpower, and use of laminar flow cabinets in  the Pharmacy Department. Costs were measured in Euros.

Results: A statistically significant difference was found between processing times in the Pharmacy Department and those in the hospital care unit (2.10 vs 2.86 minutes). Centralized preparation in the Pharmacy Department  was more efficient. The average cost of preparation was €5.24±1.45 in the  Pharmacy Department and €5.62±1.55 in the hospital care unit, although this  difference did not reach statistical significance. If the analysis had included the  cost of intravenous mixtures that had expired prior to their use, the centralized  preparation of the mixtures in the Pharmacy Department would have entailed a  higher cost (€2 174/y).

Conclusions: The centralized preparation of intravenous mixtures in the Pharmacy Department entails significant time savings compared with their preparation in the hospital care unit.