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Methods Our acute hospital’s spend on inhaled therapy is high, and was rising year on year. It is recognised that ‘stockpiling’ of inhaled therapy occurs, and that patients often don’t bring in their inhalers when admitted acutely. In October 2016 we drew up guidelines for our hospital pharmacists aiming to support them in safely deferring dispensing inhalers, allowing time for patients to arrange for inhalers to be brought in from home. We developed a flow chart, with posters displayed on the medical wards as reminders. In addition we encouraged pharmacists not to dispense a new type of inhaler unless the patient had been assessed as able to use it by the Respiratory Nurse Specialist. From April 2016 we also started actively changing patients from high cost to lower cost devices, matching the local CCG prescribing incentive scheme for 2016–2017. Results Following the ‘Defer Dispensing’ programme there was a 28% reduction in spend on inhaled therapy and a 6.5% reduction in the number of items dispensed, (See Table). Using 2016–2017 figures the average cost of inhalers dispensed was £14.21, giving a saving of £10 757 related to reduced number of items dispensed. In the first 3 months of this year (2017–2018) there has been an additional 23% cost reduction compared to previous year’s equivalent time period and a 5.2% reduction in number of items dispensed. Conclusion There is scope to impact on respiratory pharmacy spend in acute trusts. This was achieved both by swapping to lower cost preparations, with ongoing benefit to the local health economy, plus a reduction in the number of items dispensed. We believe that there is potential for further savings by making dispensing of inhaled therapy a more robust process. |
