Pharmacoeconomics of intravenous drug administration.

Direct administration of a drug into a vein guarantees bioavailability, i.e. the total amount of drug is fully available to the bloodstream for transport to all areas of the body. What is not ensured is the safety, need and 'value for money' of this route. Few workers would disagree that there is increased morbidity associated with this method of administration. Adverse events range from the painful irritation of veins to life-threatening infection introduced by needle puncture. It is proposed that in many situations the disadvantages of the intravenous (IV) route outweigh the advantages. There are many hidden costs of IV therapy ranging from the adverse events associated with IV administration to the need for specialised equipment, consumables and additional personnel time. Recent studies have shown that the oral route can be substituted in many patients receiving IV therapy without loss of efficacy. The reduction in costs intrinsic to IV therapy is an additional bonus. There is a need to increase the use of alternative routes of administration on the basis of safety, quality of life and cost.