scholarly journals A New Mechanism To Identify Cost Savings in NHS Prescribing: Minimising “Price-Per-Unit”

2017 ◽  
Author(s):  
Richard Croker ◽  
Alex J Walker ◽  
Seb Bacon ◽  
Helen J Curtis ◽  
Lisa French ◽  
...  
Keyword(s):  
General Practice ◽  
Drug Cost ◽  
National Policy ◽  
Cost Savings ◽  
New Method ◽  
Potential Cost ◽  
Core Element ◽  
Generic Prescribing ◽  
Prescription Costs ◽  
Ingredient Cost

AbstractBackgroundMinimising prescription costs while maintaining quality is a core element of delivering high value healthcare. There are various strategies to achieve savings, but almost no research to date on determining the most effective approach. We describe a new method of identifying potential savings due to large national variations in drug cost, including variation in generic drug cost; and compare these with potential savings from an established method (generic prescribing).MethodsWe used English NHS Digital prescribing data, from October 2015 to September 2016. Potential cost savings were calculated by determining the price-per-unit (e.g. pill, ml) for each drug and dose within each general practice. This was compared against the same cost for the practice at the lowest cost decile, to determine achievable savings. We compared these price-per-unit savings to the savings possible from generic switching; and determined the chemicals with the highest savings nationally. A senior pharmacist manually assessed whether a random sample of savings were practically achievable.ResultsWe identified a theoretical maximum of £410M of savings over 12 months. £273M of these savings were for individual prescribing changes worth over £50 per practice per month; this compares favorably with generic switching, where only £35M of achievable savings were identified. The biggest savings nationally were on glucose blood testing reagents (£12M), fluticasone propionate (£9M) and venlafaxine (£8M). Approximately half of all savings were deemed practically achievable.DiscussionWe have developed a new method to identify and enable large potential cost savings within NHS community prescribing. Given the current pressures on the NHS, it is vital that these potential savings are realised. Our tool enabling doctors to achieve these savings is now launched in pilot form. However savings could potentially be achieved more simply through national policy change.AbbreviationsBNFBritish National FormularyCCGClinical Commissioning GroupGPGeneral PracticeMRModified ReleaseNHSNational Health ServiceNICNet Ingredient CostNP8Non-Part VIII, i.e. drugs not listed in Part VIII of the Drug TariffPPUPrice-Per-Unit

scholarly journals New mechanism to identify cost savings in English NHS prescribing: minimising ‘price per unit’, a cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e019643 ◽  
Author(s):  
Richard Croker ◽  
Alex J Walker ◽  
Seb Bacon ◽  
Helen J Curtis ◽  
Lisa French ◽  
...  
Keyword(s):  
Drug Cost ◽  
National Policy ◽  
Cost Savings ◽  
Cross Sectional Study ◽  
New Method ◽  
Potential Cost ◽  
Core Element ◽  
Cross Sectional ◽  
Generic Prescribing ◽  
Prescription Costs

BackgroundMinimising prescription costs while maintaining quality is a core element of delivering high-value healthcare. There are various strategies to achieve savings, but almost no research to date on determining the most effective approach. We describe a new method of identifying potential savings due to large national variations in drug cost, including variation in generic drug cost, and compare these with potential savings from an established method (generic prescribing).MethodsWe used English National Health Service (NHS) Digital prescribing data, from October 2015 to September 2016. Potential cost savings were calculated by determining the price per unit (eg, pill, millilitre) for each drug and dose within each general practice. This was compared against the same cost for the practice at the lowest cost decile to determine achievable savings. We compared these price-per-unit savings to the savings possible from generic switching and determined the chemicals with the highest savings nationally. A senior pharmacist manually assessed whether a random sample of savings were practically achievable.ResultsWe identified a theoretical maximum of £410 million of savings over 12 months. £273 million of these savings were for individual prescribing changes worth over £50 per practice per month (mean annual saving £33 433 per practice); this compares favourably with generic switching, where only £35 million of achievable savings were identified. The biggest savings nationally were on glucose blood testing reagents (£12 million), fluticasone propionate (£9 million) and venlafaxine (£8 million). Approximately half of all savings were deemed practically achievable.DiscussionWe have developed a new method to identify and enable large potential cost savings within NHS community prescribing. Given the current pressures on the NHS, it is vital that these potential savings are realised. Our tool enabling doctors to achieve these savings is now launched in pilot form at OpenPrescribing.net. However, savings could potentially be achieved more simply through national policy change.

Integrated Tubulars Supply Model Provides Cost Savings to Drilling Projects

2020 ◽  
Author(s):  
M. Hamzah
Keyword(s):  
Supply Chain ◽  
Cost Savings ◽  
Asia Pacific ◽  
Potential Cost ◽  
Alternative Scheme ◽  
Safety Stocks ◽  
Storage Location ◽  
Supply Planning ◽  
Drilling Site ◽  
Drilling Project

Classical Oil Country Tubular Goods (OCTG) procurement approach has been practiced in the indus-try with the typical process of setting a quantity level of tubulars ahead of the drilling project, includ-ing contingencies, and delivery to a storage location close to the drilling site. The total cost of owner-ship for a drilling campaign can be reduced in the range of 10-30% related to tubulars across the en-tire supply chain. In recent decades, the strategy of OCTG supply has seen an improvement resulting in significant cost savings by employing the integrated tubular supply chain management. Such method integrates the demand and supply planning of OCTG of several wells in a drilling project and synergize the infor-mation between the pipes manufacturer and drilling operators to optimize the deliveries, minimizing inventory levels and safety stocks. While the capital cost of carrying the inventory of OCTG can be reduced by avoiding the procurement of substantial volume upfront for the entire project, several hidden costs by carrying this inventory can also be minimized. These include storage costs, maintenance costs, and costs associated to stock obsolescence. Digital technologies also simplify the tasks related to the traceability of the tubulars since the release of the pipes from the manufacturing facility to the rig floor. Health, Safety, and Environmental (HSE) risks associated to pipe movements on the rig can be minimized. Pipe-by-pipe traceability provides pipes’ history and their properties on demand. Digitalization of the process has proven to simplify back end administrative tasks. The paper reviews the OCTG supply methods and lays out tangible improvement factors by employ-ing an alternative scheme as discussed in the paper. It also provides an insight on potential cost savings based on the observed and calculated experiences from several operations in the Asia Pacific region.

Improved Oxygen Dissolution Control for Oxygen Activated Sludge

1988 ◽  
Vol 20 (4-5) ◽  
pp. 101-108 ◽  
Author(s):  
R. C. Clifft ◽  
M. T. Garrett
Keyword(s):  
Activated Sludge ◽  
Control Method ◽  
Control Strategies ◽  
Cost Savings ◽  
Utilization Efficiency ◽  
Oxygen Production ◽  
Oxygen Utilization ◽  
Potential Cost ◽  
Oxygen Dissolution ◽  
The City

Now that oxygen production facilities can be controlled to match the requirements of the dissolution system, improved oxygen dissolution control can result in significant cost savings for oxygen activated sludge plants. This paper examines the potential cost savings of the vacuum exhaust control (VEC) strategy for the City of Houston, Texas 69th Street Treatment Complex. The VEC strategy involves operating a closed-tank reactor slightly below atmospheric pressure and using an exhaust apparatus to remove gas from the last stage of the reactor. Computer simulations for one carbonaceous reactor at the 69th Street Complex are presented for the VEC and conventional control strategies. At 80% of design loading the VEC strategy was found to provide an oxygen utilization efficiency of 94.9% as compared to 77.0% for the conventional control method. At design capacity the oxygen utilization efficiency for VEC and conventional control was found to be 92.3% and 79.5%, respectively. Based on the expected turn-down capability of Houston's oxygen production faciilities, the simulations indicate that the VEC strategy will more than double the possible cost savings of the conventional control method.

Cost-minimization analysis of drugs used in the treatment of Asthma and COPD diseases in India

2020 ◽  
Vol 15 ◽  
Author(s):  
Billu Payal ◽  
Anoop Kumar ◽  
Harsh Saxena
Keyword(s):  
Generic Drugs ◽  
Cost Minimization ◽  
Cost Savings ◽  
Chronic Obstructive ◽  
Pulmonary Medicine ◽  
Potential Cost ◽  
Maximum Cost ◽  
Cost Minimization Analysis ◽  
Cost Variation ◽  
The Cost

Background: Asthma and Chronic Obstructive Pulmonary Diseases (COPD) are well known respiratory diseases affecting millions of peoples in India. In the market, various branded generics, as well as generic drugs, are available for their treatment and how much cost will be saved by utilizing generic medicine is still unclear among physicians. Thus, the main aim of the current investigation was to perform cost-minimization analysis of generic versus branded generic (high and low expensive) drugs and branded generic (high expensive) versus branded generic (least expensive) used in the Department of Pulmonary Medicine of Era Medical University, Lucknow for the treatment of asthma and COPD. Methodology: The current index of medical stores (CIMS) was referred for the cost of branded drugs whereas the cost of generic drugs was taken from Jan Aushadi scheme of India 2016. The percentage of cost variation particularly to Asthma and COPD regimens on substituting available generic drugs was calculated using standard formula and costs were presented in Indian Rupees (as of 2019). Results: The maximum cost variation was found between the respules budesonide high expensive branded generic versus least expensive branded generic drugs and generic versus high expensive branded generic. In combination, the maximum cost variation was observed in the montelukast and levocetirizine combination. Conclusion: In conclusion, this study inferred that substituting generic antiasthmatics and COPD drugs can bring potential cost savings in patients.

Inpatient Insulin Pen Implementation, Waste, and Potential Cost Savings: A Community Hospital Experience

2021 ◽  
pp. 193229682110025
Author(s):  
Urooj Najmi ◽  
Waqas Zia Haque ◽  
Umair Ansari ◽  
Eyerusalem Yemane ◽  
Lee Ann Alexander ◽  
...  
Keyword(s):  
Insulin Aspart ◽  
Community Hospital ◽  
Task Force ◽  
Hospital Setting ◽  
Cost Savings ◽  
Self Management ◽  
Self Administration ◽  
Potential Cost ◽  
Hospital Leadership ◽  
Insulin Pens

Background: Insulin pen injectors (“pens”) are intended to facilitate a patient’s self-administration of insulin and can be used in hospitalized patients as a learning opportunity. Unnecessary or duplicate dispensation of insulin pens is associated with increased healthcare costs. Methods: Inpatient dispensation of insulin pens in a 240-bed community hospital between July 2018 and July 2019 was analyzed. We calculated the percentage of insulin pens unnecessarily dispensed for patients who had the same type of insulin pen assigned. The estimated cost of insulin pen waste was calculated. A pharmacist-led task force group implemented hospital-wide awareness and collaborated with hospital leadership to define goals and interventions. Results: 9516 insulin pens were dispensed to 3121 patients. Of the pens dispensed, 6451 (68%) were insulin aspart and 3065 (32%) were glargine. Among patients on insulin aspart, an average of 2.2 aspart pens was dispensed per patient, but only an estimated 1.2 pens/patient were deemed necessary. Similarly, for inpatients prescribed glargine, an average of 2.1 pens/patient was dispensed, but only 1.3 pens/patient were necessary. A number of gaps were identified and interventions were undertaken to reduce insulin pen waste, which resulted in a significant decrease in both aspart (p = 0.0002) and glargine (p = 0.0005) pens/patient over time. Reductions in pen waste resulted in an estimated cost savings of $66 261 per year. Conclusions: In a community hospital setting, identification of causes leading to unnecessary insulin dispensation and implementation of hospital-wide staff education led to change in insulin pen dispensation practice. These changes translated into considerable cost savings and facilitated diabetes self-management education.

scholarly journals Constrained Urban Airspace Design for Large-Scale Drone-Based Delivery Traffic

Aerospace ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 38
Author(s):  
Malik Doole ◽  
Joost Ellerbroek ◽  
Victor L. Knoop ◽  
Jacco M. Hoekstra
Keyword(s):  
Traffic Congestion ◽  
Urban Areas ◽  
Large Scale ◽  
Cost Savings ◽  
Future Research ◽  
Fast Time ◽  
Potential Cost ◽  
Horizontal Structure ◽  
Traffic Demand ◽  
Demand Patterns

Large-scale adoption of drone-based delivery in urban areas promise societal benefits with respect to emissions and on-ground traffic congestion, as well as potential cost savings for drone-based logistic companies. However, for this to materialise, the ability of accommodating high volumes of drone traffic in an urban airspace is one of the biggest challenges. For unconstrained airspace, it has been shown that traffic alignment and segmentation can be used to mitigate conflict probability. The current study investigates the application of these principles to a highly constrained airspace. We propose two urban airspace concepts, applying road-based analogies of two-way and one-way streets by imposing horizontal structure. Both of the airspace concepts employ heading-altitude rules to vertically segment cruising traffic according to their travel direction. These airspace configurations also feature transition altitudes to accommodate turning flights that need to decrease the flight speed in order to make safe turns at intersections. While using fast-time simulation experiments, the performance of these airspace concepts is compared and evaluated for multiple traffic demand densities in terms of safety, stability, and efficiency. The results reveal that an effective way to structure drone traffic in a constrained urban area is to have vertically segmented altitude layers with respect to travel direction as well as horizontal constraints imposed to the flow of traffic. The study also makes recommendations for areas of future research, which are aimed at supporting dynamic traffic demand patterns.

scholarly journals Self-fill oxygen technology: benefits for patients, healthcare providers and the environment

Breathe ◽  
2016 ◽  
Vol 12 (2) ◽  
pp. 113-119 ◽  
Author(s):  
Phyllis Murphie ◽  
Nick Hex ◽  
Jo Setters ◽  
Stuart Little
Keyword(s):  
Positive Impact ◽  
Healthcare Providers ◽  
Cost Savings ◽  
Cost Effective ◽  
Evidence Base ◽  
Environmental Benefits ◽  
List Type ◽  
Potential Cost ◽  
Unlimited Supply ◽  
Technology Benefits

“Non-delivery” home oxygen technologies that allow self-filling of ambulatory oxygen cylinders are emerging. They can offer a relatively unlimited supply of ambulatory oxygen in suitably assessed people who require long-term oxygen therapy (LTOT), providing they can use these systems safely and effectively. This allows users to be self-sufficient and facilitates longer periods of time away from home. The evolution and evidence base of this technology is reported with the experience of a national service review in Scotland (UK). Given that domiciliary oxygen services represent a significant cost to healthcare providers globally, these systems offer potential cost savings, are appealing to remote and rural regions due to the avoidance of cylinder delivery and have additional lower environmental impact due to reduced fossil fuel consumption and subsequently reduced carbon emissions. Evidence is emerging that self-fill/non-delivery oxygen systems can meet the ambulatory oxygen needs of many patients using LTOT and can have a positive impact on quality of life, increase time spent away from home and offer significant financial savings to healthcare providers.Educational aimsProvide update for oxygen prescribers on options for home oxygen provision.Provide update on the evidence base for available self-fill oxygen technologies.Provide and update for healthcare commissioners on the potential cost-effective and environmental benefits of increased utilisation of self-fill oxygen systems.

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