PPI Drug Shortage Prompts Change

Although they had faced prescriber resistance to efforts to limit the use of intravenous proton pump inhibitors (PPIs) in the past, pharmacists dealing with a shortage of a specific intravenous PPI implemented changes that, to date, have saved nearly $200,000, according to a recent study.

Writing in BMG Quality & Safety, pharmacists from the University of Texas Southwestern Medical Center called the turn of events “serendipitous” (doi: 10.1136/bmjqs-2017-007015).

The shortage of the intravenous PPI (pantoprazole) in March 2015 was accompanied by a price hike of 344% from secondary sources. When pharmacists subsequently reviewed all intravenous PPIs prescribed the year before the shortage, they found they accounted for nearly $12,000 a month in costs.

The review also showed that most of the orders came not from intensive care units, postoperative care units, or emergency departments, but from wards.

Driven by the drug shortage and mounting cost concerns that even prescribers could no longer ignore, pharmacists implemented interventions that dropped intravenous PPI use 76%. After the shortage resolved, the interventions remained in effect, according to the findings, and an estimated $200,000 has been saved.

“More importantly, prescribing practices changed,” according to the authors of the study. “Prescribers were more likely to use prebuilt order sets, and pharmacists were less likely to have to intervene.”

—Jolynn Tumolo