Exploring differences in inpatient drug purchasing cost between two pediatric hospitals.

OBJECTIVES: In this study, the hospital cost of purchasing drugs at two children's hospitals is explored with respect to high-cost drugs and drug classes and discussed with regard to differences in hospital setting, drug price, or number of treatments.
METHODS: The purchasing costs of drugs at the two hospitals were retrieved and analyzed. All information was connected to the Anatomic Therapeutic Chemical code and compared in a Microsoft Access database.
RESULTS: The 6-month drug purchasing costs at Astrid Lindgren Children's Hospital (ALCH), Stockholm, Sweden, and Lucile Packard Children's Hospital at Stanford (LPCH), Palo Alto, California, are similar and result in a cost per patient day of US $149 and US $136, respectively. The hospital setting and choice of drug products are factors that influence the drug cost in product-specific ways.
CONCLUSIONS: Several problems are highlighted when only drug costs are compared between hospitals. For example, the comparison does not take into account the amount of waste, risk of adverse drug events, local dosing strategies, disease prevalence, and national drug-pricing models. The difference in cost per inpatient day at ALCH may indicate that cost could be redistributed in Sweden to support pediatric pharmacy services. Also, when introducing new therapies seen at the comparison hospital, it may be possible to extrapolate the estimated increase in cost.