Pharmacist-led initiatives save millions

At the virtual 2020 Midyear Clinical Meeting and Exposition of the American Society of Health-System Pharmacists (ASHP), pharmacists in Nebraska discussed a diabetes stewardship pharmacist program launched at the University of Nebraska Medical Center in Omaha. The program featured specially trained pharmacists, including a dedicated pharmacist for monitoring glycemic control and fluctuations in blood sugar in hospitalized patients. Nebraska Medicine experienced a roughly 65% reduction in hypoglycemia (–70 mg/dL) in critical care units and a nearly 50% reduction in such readings in non–critical care units from January 2015 through June 2020, said Jon Knezevich, PharmD, the hospital’s diabetes stewardship pharmacist. “This translates to an estimated cumulative length of stay reduction of 0.46 days and greater than $690,000 in cost avoidance annually, along with an additional $150,000 in cost savings from formulary management strategies,” he explained. He said that some of those savings can be attributed to reducing and simplifying insulin analog formulations on the inpatient formulary, and adding multiuse insulin vials into the nursing workflow. Meanwhile, Kalispell Regional Medical Center in Montana found that involving pharmacy stakeholders and selecting a PBM that offered a better employee prescription benefit helped save $1.19 million in the first year of its change. Hugh Easley, PharmD, director of pharmacy services, and his team made plan design changes with their PBM related to specialty medications, which were previously handled through an outsourced mail-order pharmacy. For employee prescription costs in its self-funded plan, most of the member-per-month savings were achieved by in-sourcing pharmacy services and maximizing the purchase of preferred generics and tier 1 formulary drugs.