OBJECTIVE: Several medications are equally efficacious regardless of dosage form. This study conducted a cost-minimization analysis from an institutional perspective of a pharmacist-directed intravenous to oral conversion program for pantoprazole, a proton pump inhibitor (PPI). Empirical evidence supports equivalence of IV and tablet forms of pantoprazole in inhibiting gastric acid secretion. METHODS: Patients on IV pantoprazole in select units at a tertiary care teaching hospital between March 15, 2002 and April 12, 2002 were included in the intervention group. Following a protocol approved by the Pharmacy & Therapeutics Committee, a pharmacist evaluated patients to determine eligibility for conversion to administration by mouth or nasogastric tube. The pharmacist recorded times required to identify and switch patients. Average times required for preparation, dispensing, and administration of dosage forms were determined via employee interview. Medication acquisition and labor costs were obtained from the hospital financial department. Proportion of days therapy with each dosage form for the intervention group and historical control group, which otherwise met identical inclusion criteria, were determined from the pharmacy database. RESULTS: A significant difference in proportion of days therapy with PPI dosage forms existed between control (N=182) and intervention (N=150) groups (C2=276.39, df=2, p<0.05). The intervention increased total proportion of days therapy with pantoprazole tablets and PPI suspensions by 6.9% and 22.0%, respectively. Days therapy with IV pantoprazole were decreased by 28.8% (from 61.2% to 32.4%). Applying costs for medications, supplies, and labor, the conversion program saves $13.45/patient started on IV pantoprazole. Projecting cost saving to 1 year with 1887 patients/year, the conversion program could save $25,380.15 in the hospital budget. CONCLUSION: A pharmacist-directed intravenous to oral dosage form conversion program can result in institutional cost savings. However, cost savings are dependent on success in converting patients. Cost savings would be increased to $18.50/patient on IV pantoprazole by shifting an additional 6.9% of PPI therapy days from IV pantoprazole to pantoprazole tablets.