High Cost Medication Information Poster

1
High Cost Medication Information Poster Hilary
Oldham, Joan Karasu, Emma Lowe, Sharon Platt
Clinical service technicians, Pharmacy
Department, Christie NHS Foundation Trust
Introduction
found the poster informative 88 said they were
unaware of the actual cost 50 said that knowing
this information would have an impact on their
current practice.
Due to the specialist nature of the Trust the
usage of high cost medication is a routine and
regular occurrence. The main aim of this service
evaluation is to increase ward staff knowledge
and awareness of high value medication used
within the Trust. This will hopefully impact on
the wastage and cost savings as staff may be more
vigilant when prescribing, reviewing, storing,
reconstituting and administering such medication.
Feedback after the poster
Method

• A short questionnaire was distributed to a
  complete nursing
• shift on each of our main in-patient wards (a
  total of 18
• nurses), in order to gain an insight as to
  whether the ward
• staff would find such information regarding
  high cost
• medication helpful.
• The clinical technicians analysed, discussed
  and identified
• the most commonly used high cost medicines on
  the wards
• within our Trust.
• A laminated A4 information poster of commonly
  prescribed
• high cost medication in the Trust was
  produced, following
• infection control protocol and using current
  and accurate
• information from the BNF.
• This poster was displayed in the treatment
  areas on the
• main in-patient wards.
• A second short questionnaire was then
  distributed to a
• complete nursing shift on each of our main
  in-patient wards
• (a total of 18 nurses), to see if the nursing
  staff had found
• the poster useful.

• Comments from the nursing staff on the wards
  included this would prompt me to ask the
  prescriber to review a high cost medication, I
  will be more vigilant to get the stock back from
  other wards when they borrow it, I was shocked
  by how much some of these medications actually
  cost, I think this would be more appropriate in
  the prescribers office.
• The poster allows the nursing staff to be more
  proactive regarding course length, review dates
  set and changes from IV to oral medication as
  soon as appropriate. It also allows the staff to
  determine the most economical combinations of
  strengths to provide the dose required. For
  example, rasburicase for a dose of 12mg, using a
  7.5mg vial and three 1.5mg vials is significantly
  cheaper than using two 7.5mg vials over a course
  of 5 days.

Results/Discussion
Initial Feedback
Conclusion
Staff found that the poster was informative but
didnt realise quite how much the high cost items
were and the cost implications of failing to
review such medications in a timely manner.
Although one dose extra in itself would not seem
excessively expensive, mirrored throughout the
Trust over a period of 12 months, this can mount
up with the sheer volume prescribed. Due to the
regular use of some of these medicines there was
a degree of complacency without regard for cost.
Feedback from the staff suggested that it would
be useful to have a second poster displayed in
the medical prescribers office to aid increase
awareness of cost implications. The poster will
require annual review to update.
For the initial questionnaire 44 of nurses
questioned said that they were aware of which
high cost medication is used on the ward 78 of
nurses asked said they would find it useful to
know which drugs are high cost and the cost
involved 11 said they would not treat the
medication differently (few comments about
treating all medication the same) and 28 felt
that there was some wastage of drugs on the ward.
Following the display of the poster on the wards,
final questionnaire showed that 75 said that
they
References
1. Joint Formulary Committee. British National
Formulary (online) London BMJ Group and
Pharmaceutical Press lthttp//www.medicinescomplet
e.comgt Accessed on 7/04/13
Date of preparation 23/09/13