POTENTIAL SAVINGS FROM THE IMPLEMENTATION OF PHARMACEUTICAL COST CONTAINMENT GUIDELINES IN HOSPITALS
Author(s)
Oakar Skarayadi, Master.
Phd Student, Unjani, Bandung, Indonesia.
Phd Student, Unjani, Bandung, Indonesia.
OBJECTIVES: This study evaluated the potential cost savings associated with implementing selected pharmaceutical cost containment strategies from pharmaceutical cost containment guidelines in Indonesian hospitals
METHODS: A retrospective descriptive study was conducted using secondary data from three hospitals in different provinces. Four pharmaceutical cost-containment strategies were evaluated: (1) comparison of hospital costs with INA-CBG reimbursement tariffs, (2) generic drug substitution, (3) compliance with the National Formulary (Fornas) and hospital formularies, and (4) adherence to clinical pathways for patients with ST-elevation myocardial infarction (STEMI). A total of 600 outpatient cardiovascular prescriptions from each hospital were analyzed for the initial three strategies. The clinical pathway evaluation included all eligible hospitalized STEMI patients. The potential cost savings were estimated by comparing the current and projected costs after the implementation of the recommended strategies.
RESULTS: The INA-CBG reimbursement tariff cost analysis showed potential savings of IDR 67,190,223 (35.55%) at Hospital A (type B public hospital), IDR 37,177,476 (9.60%) at Hospital B (type C private hospital), and IDR 52,034,782 (29.76%) at Hospital C (type C public hospital). Substituting generic drugs resulted in additional savings of IDR 8,573,313 at Hospital A, IDR 5,484,136 at Hospital B, and IDR 172,328 at Hospital C. Adherence to hospital formularies was 100%, and adherence to the National Formulary surpassed 98%, suggesting minimal further savings from formulary optimization. Among 42 hospitalized STEMI patients at Hospital C, only 50.0% underwent medication reconciliation, 4.76% received comprehensive pharmaceutical care, and 45.24% did not receive pharmaceutical services according to the clinical pathway, precluding accurate estimation of potential cost savings.
CONCLUSIONS: Improving adherence to clinical pathways offers the greatest opportunity for future cost savings because implementation remains suboptimal. Cost analysis based on INA-CBG reimbursement tariffs and generic drug substitution also demonstrated substantial savings potential, whereas formulary compliance offered minimal additional economic benefit because adherence was already high.
METHODS: A retrospective descriptive study was conducted using secondary data from three hospitals in different provinces. Four pharmaceutical cost-containment strategies were evaluated: (1) comparison of hospital costs with INA-CBG reimbursement tariffs, (2) generic drug substitution, (3) compliance with the National Formulary (Fornas) and hospital formularies, and (4) adherence to clinical pathways for patients with ST-elevation myocardial infarction (STEMI). A total of 600 outpatient cardiovascular prescriptions from each hospital were analyzed for the initial three strategies. The clinical pathway evaluation included all eligible hospitalized STEMI patients. The potential cost savings were estimated by comparing the current and projected costs after the implementation of the recommended strategies.
RESULTS: The INA-CBG reimbursement tariff cost analysis showed potential savings of IDR 67,190,223 (35.55%) at Hospital A (type B public hospital), IDR 37,177,476 (9.60%) at Hospital B (type C private hospital), and IDR 52,034,782 (29.76%) at Hospital C (type C public hospital). Substituting generic drugs resulted in additional savings of IDR 8,573,313 at Hospital A, IDR 5,484,136 at Hospital B, and IDR 172,328 at Hospital C. Adherence to hospital formularies was 100%, and adherence to the National Formulary surpassed 98%, suggesting minimal further savings from formulary optimization. Among 42 hospitalized STEMI patients at Hospital C, only 50.0% underwent medication reconciliation, 4.76% received comprehensive pharmaceutical care, and 45.24% did not receive pharmaceutical services according to the clinical pathway, precluding accurate estimation of potential cost savings.
CONCLUSIONS: Improving adherence to clinical pathways offers the greatest opportunity for future cost savings because implementation remains suboptimal. Cost analysis based on INA-CBG reimbursement tariffs and generic drug substitution also demonstrated substantial savings potential, whereas formulary compliance offered minimal additional economic benefit because adherence was already high.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HPR116
Topic
Health Policy & Regulatory, Health Service Delivery & Process of Care, Health Technology Assessment
Topic Subcategory
Insurance Systems & National Health Care, Pricing Policy & Schemes, Reimbursement & Access Policy
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory)