CP-166 Impact of guideline implementation on albumin and intravenous pantoprazole expenditure in a referral teaching hospital, Tehran, Iran

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Irrational use of medicines is a widespread problem in healthcare and imposes huge costs on health systems.


To promote rational drug prescription and expenditure, we performed a study on albumin and pantoprazole expenditure in our hospital.

Material and methods

A cross sectional study was conducted to examine the role of a restrictive protocol on intravenous pantoprazole and albumin consumption. The protocol was designed by clinical pharmacists and after approval by a drug and therapeutics committee, was presented to hospital wards. The pharmacists from the hospital pharmacy approved dispensing of pantoprazole and albumin to medical wards only if the physician’s order accompanied a signed paper protocol and the prescription conformed to the protocol. Otherwise, the pharmacist consulted with the physician to prescribe appropriate alternatives. The average consumption and cost of albumin and pantoprazole were analysed, comparing 3 months before with 3 months after protocol enforcement. The average number of consumed vials per month and related expenditure were obtained from the hospital information system.


The average monthly consumption of albumin was 1832 vials before and 858 vials after the intervention. The mean albumin cost per hospital bed day was $2.6 before and $1.5 after the intervention, leading to a cost difference of about $1.1 per hospital bed day with a mean monthly saving of about $29 751 (43% decline in albumin expenditure). The mean monthly consumption of intravenous pantoprazole was 6043 vials before and 4713 vials after the intervention. The mean expenses per hospital bed day was $7.6 before and $6.2 after implementing the intervention. The protocol successfully decreased pantoprazole consumption by $1.4 per hospital bed day with a mean monthly saving of about $38 803. (Approximately 19% reduction in monthly pantoprazole expenditure.)


Our study confirms that our protocol may substantially reduce albumin and pantoprazole use and lead to significant cost savings.


No conflict of interest

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