Every aspect of patient care, particularly cost effectiveness must be scrutinized. When a drug class that accounts for a large portion of the pharmacy budget comprises agents that are similar in safety and efficacy, strong consideration must be given to restricting the use of the more expensive drugs in that class and to also evaluate patient outcomes following the expense control initiative. At our institution, H2-receptor antagonist use accounted for a large percent of the annual total drug budget. However, due to the controversial nature of the proposed formulary change, it became prudent to assess treatment outcomes as well as the effects which this formulary change had on patient care. This presentation will describe a prospective cost-effectiveness evaluation of cimetidine and famotidine for stress ulcer prophylaxis and the treatment of gastrointestinal bleeding.
Decision analysis is utilized to evaluate the global treatment costs associated with each therapy.
A cost-benefit analysis will be performed and presented. By including MAUT in the evaluation of the H2-receptor antagonists, clinical, financial, and humanistic factors can be integrated as part of the formulary decision making process.