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Drug Switching: The Bottom Line Isn't Always What It Seems

8005 Archer Circle, Tallahassee, FL 32308

Curtis M. Warren, RPh

Pharmacy services for the Florida Department of Corrections, Tallahassee

David L. Thomas, MD, JD

Department of Surgery, Nova Southeastern University College of Medicine, Ft. Lauderdale, Florida

Objectives: To study the clinical effects and costs of a formulary conversion from omeprazole to lansoprazole in the Florida prison system. Methods: Drug utilization patterns were studied before and after the conversion to determine whether the switch reduced drug acquisition cost. In addition, the charts of 29 patients from six sites were reviewed to evaluate the clinical consequences of the conversion. Results: The switch significantly increased (p = 0.006) the need for twice-daily administration, total daily dose from 24.8 mg to 30 mg, and the need for add-on medications to control acid-related symptoms (p = 0.043). Drug acquisition costs rose by nearly $24,000. Conclusions: Formulary conversions based solely on anticipated reductions in drug acquisition costs may not achieve the intended financial savings.

Journal of Correctional Health Care, Vol. 10, No. 2, 227-237 (2004)
DOI: 10.1177/107834580301000207


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