Changing Prescribing Practices in Osteoporosis Result in Cost Saving in the Infusion Suite
Azhar Abbas, Hafiz Bajwa, Maria Khan,Grainne Kearns,Dr Donough Howard,Paul O' Connell, Laura Durkin
Rheumatology Department, Beaumont Hospital , Dublin
Osteoporosis is a chronic disease with associates with accelerated mortality, disability and fragility. The treatment of osteoporosis is hindered by adherence, intolerance and inefficacy. We have previously used infusional bisphosphonates to overcome some of these issues.
Comparison of change of practice and evaluation of cost saving.
We performed a retrospective review of infusion service use for the management of osteoporosis in Beaumont hospital and compared practices in 2014 to 2017 to ascertain whether therapeutic advances have impacted upon service provision. A secondary aim was to evaluate any cost saving which could be attributed to these changes in practice. Data collected, from 2014 and 2017 included age, gender, T score where available, number of infusions and reason for bisphosphonate.
There were 19 individuals receiving yearly bisphosphonate infusions in 2014 compared with 3 in 2017. See Table 1. for a comparison of 2014 to 2017 in terms of age, gender, number of infusions and indications for treatment. The cost of yearly infused bisphosphonate is more than € 500 ( not inclusing the infusion costs which are considerable ) , which is shouldered by the institution, compared to denosumab, or oral bisphosphonates with are administered and acquired in the community.
Therapeutic advances now mean that we are utilising the infusion room less and less with resultant cost saving to the hospital and department. In osteoporosis, prescribing practices have changed considerably in the last 3 years and the resultant cost saving should be highlighted.