THE INCREASED COST OF TREATING PATIENTS WITH
LEVALBUTEROL IS MORE THAN OFFSET BY A REDUCTION IN TREATMENT
FREQUENCY AND ASSOCIATED LABOR COSTS.
Edward Amend BS, RRT, Bruce Burns, MA, RRT, RPFT, John Wolfe,
RRT, CPFT Northern Colorado Medical Center, Greeley, CO.
Background: By substituting levalbuterol in place of
racemic albuterol we reduced the average number of treatments per
patient stay during March - May of 2005 by 22% compared to the same
time period the year before. Levalbuterol is more expensive ($2.09
per dose) compared to albuterol ($0.31per dose) or albuterol and
ipratropium ($0.46), but levalbuterol is typically administered Q8
hours (3 times per day) compared to four to six times per day for
albuterol or albuterol and ipratropium. We wanted to determine if
the increased cost of the drug was offset by decreased labor costs
associated with a reduction in the number of treatments required per
Method: During March through May of
2005, we initiated a protocol substituting levalbuterol at Q8 hour
and Q4 PRN intervals in place of albuterol or albuterol with
ipratropium at QID or Q4 hour intervals to adult in-patients
receiving nebulized breathing treatments. Our substitution protocol
and analysis excluded all ventilated, pediatric, and emergency
Results: We experienced a 29%
increase in the number of patients requiring nebulized breathing
treatments during 2005 (956) compared to the same period in 2004
(741). Total projected savings for the study period ($103,939 -
$92,169) was $11,770 utilizing the levalbuterol protocol.
||2004 study period
||2005 PROJECTED without lev.
||2005 ACTUAL with lev.|
|Total # of tx's
|# of patients
|Avg tx's per patient
|Tx's x 16 min.
|Labor costs @ 24/hr
Conclusion: Instituting the levalbuterol protocol
substantially decreased the average number of treatments per patient
stay. The increased cost of using levalbuterol was more than offset
by savings in labor costs. In addition, we did not have to recruit
additional staff or use any agency workers to respond to the upsurge
in census during the study period.