1. Drug costs and utilization after implementation of a posaconazole prophylaxis protocol in adults with acute myelogenous leukemia.
- Author
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Nemerovski CW, Mackler ER, DePestel DD, Collins CD, Welch KS, and Stevenson JG
- Subjects
- Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents adverse effects, Anti-Bacterial Agents economics, Antifungal Agents adverse effects, Antineoplastic Agents administration & dosage, Antineoplastic Agents adverse effects, Antineoplastic Agents economics, Drug Utilization economics, Female, Humans, Leukemia, Myeloid, Acute economics, Leukemia, Myeloid, Acute microbiology, Male, Middle Aged, Mycoses chemically induced, Mycoses economics, Pharmacy Service, Hospital economics, Retrospective Studies, Triazoles adverse effects, Triazoles economics, Antifungal Agents administration & dosage, Antifungal Agents economics, Drug Costs, Leukemia, Myeloid, Acute drug therapy, Mycoses prevention & control, Triazoles administration & dosage
- Abstract
Purpose: Drug costs and utilization after implementation of a posaconazole prophylaxis protocol in adults with acute myelogenous leukemia (AML) were studied., Methods: Adult patients who initiated induction or reinduction chemotherapy for the treatment of AML between December 1, 2006, and March 31, 2008, at a tertiary care hospital were included in this retrospective cohort study. Patients were divided into two groups: preprotocol (treated before June 1, 2007) and postprotocol (treated on or after June 1, 2007). Medical charts, including pharmacy and laboratory data, were reviewed for all patients. Outcomes measured included antifungal and antibacterial drug costs and utilization and total pharmacy costs., Results: A total of 66 patients were evaluated (33 in each group). Baseline characteristics, except patient age, were similar between groups. Each group incurred similar costs and utilized resources for similar periods of time as evidenced by similar lengths of stay, duration of neutropenia, and mortality. Antibacterial costs, total pharmacy costs, and other utilization outcomes were also similar between the two groups. Alterations to antifungal management strategy occurred more often in the postprotocol group (33% versus 58%, p = 0.048)., Conclusion: Implementation of a posaconazole protocol did not significantly alter antifungal or antibacterial drug costs or utilization or total pharmacy costs. Prophylactic posaconazole was frequently changed to alternative antifungal therapy due to an adverse drug event, perceived lack of efficacy, avoidance of a drug interaction, or inability to tolerate oral intake.
- Published
- 2010
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