Pharmacy-Administered IV to Oral Therapeutic Interchange Program: Development, Implementation, and Cost-Assessment

Abstract

This study describes the development, implementation, and estimated vs. actual cost benefits of an IV to oral therapeutic interchange program. Secondary objectives were determining patient eligibility criteria and selecting medications for future inclusion in the program. Medical charts were reviewed to determine which patients were appropriate candidates for the interchange. Targeted medications were selected by reviewing the literature and the institution's drug expenditures. Five medications — famotidine, ciprofloxacin, levofloxacin, fluconazole, and azithromycin — were selected for the initial stages of the program. Preimplementation cost analysis suggested that the interchange would yield cost savings of more than $30,000 per year in medication costs alone. The interchange was piloted on a single nursing unit to determine best procedures and possible barriers to implementation. Data collected in the first 6 months after implementation indicated greater potential cost benefits than originally estimated. Including more medications in the interchange would further reduce drug acquisition costs.