A practical approach to achieving a $950,000 cost savings from a joint anesthesia-pharmacy program.

This report describes a joint anesthesia-pharmacy program to change prescribing and use of neuromuscular blocking agents and narcotic analgesics. The program uses pancuronium and fentanyl as "workhorse" agents with more expensive, shorter acting agents used for short-duration cases and for patients with characteristics such as renal and hepatic insufficiency that may affect the duration of action of other neuromuscular blocking agents. Cost-savings associated with changes in drug-prescribing were tracked. Some savings were applied to the planning and implementation of a pharmacy operating room satellite. A cost-savings exceeding $950,000 during a 3-year period was achieved.