Table 5.
Degree of Financial savings
| Interventions studies | Degree of financial saving. {NB this is overestimated for any other denominator other than total health systems costs} | Proportion of total drug costs or total health system costs |
|---|---|---|
| IMCI guidelines (Tanzania) | Costs of drugs were higher by 61% compared to control districts. Cost of the intervention not included. | Total drug costs for managing outpatient illness in those aged <5 years. |
| Health system costs per child were 44% lower in intervention districts than in control districts. Cost of the intervention was included. | Total health system costs (including start up and post implementation costs) for managing outpatient illness in those aged <5 years. | |
| Multidisciplinary clinical pathway for oxygen administration | Led to changes in oxygen prescribing behaviour but consumed more resources than standard management by 116%. Cost of the intervention was included. | Total health system costs (including start up and post implementation costs). |
| Multifaceted intervention to improve preventive care delivered by nurses | Costs decreased by 34%. Cost of the intervention was included. | Total health system costs (training, Supervision) |
| Use of commercially available electronic prescribing system with integrated clinical decision support and evidence - based message capability. | The proportion of prescriptions for high costs drugs that were the target of this intervention to prescribers was a relative 17.5% lower among the intervention group compared with the control group. | Total drug costs |
| Multifaceted intervention to promote early switch from intravenous to oral acetaminophen for prospective pain | Costs decrease by 57%. Cost of the intervention not included. | Total cost for acetaminophen analgesia costs |
| Clinical pathways for patients undergoing total laryngectony | Hospital variable costs decreased by 14.4% | Total hospital costs (both fixed and variable costs) |
| New antibiotics protocol involving amoxicillin as a first line agent. | Costs decrease by 28%. Cost of the intervention not included. | Total antibiotics costs |
| Educational intervention to decrease use of selected expensive medications | A 32% decrease in use of the more costly anticoagulant and a 20% increase in use of the less costly anticoagulant representing an estimated annual savings of $66000. Cost of the intervention not included. | Total anti-coagulant costs |
| Use of clinical pathway designed to manage community acquired pneumonia more efficiently than conventional therapy | Cost savings of 16%, 24% and 24% from the perspectives: healthcare, government and societal. Cost of the intervention not included. | Total consumable costs |
| Guidelines with one to one educational outreach visits by community pharmacists | Mean costs reduce by 6%. | Total drug costs including guideline production and dissemination; together with provision of education outreach visits |
| In patient diabetes management program | The reduction in length of stay for patients with diabetes has resulted in savings of more than $2 million for the year and has yielded a 467% return on investment for the hospital. | Total hospital costs |
| Modeling studies | Degree of financial saving | Proportion of total drug costs or total health system costs. |
| Malaria microscopy (change in clinical practice) | Costs of prescribed Artemether-Lumefantrine decreased by 54% while that of antibiotics increased by 5%. Therefore, the overall drug cost saving was 49%. Cost of the intervention not included. | Total Outpatient drug costs |
| IMCI guidelines (Kenya) | Cost of treatment reduced by an average of 42%. Cost of the intervention not included. | Total drug costs for managing outpatient illness in those aged <5 years |
| IMCI guidelines (Uganda) | Cost of medication reduced by 80%. Cost of the intervention not included. | Total drug costs for managing outpatient illness in those aged <5 years |
| IMCI guidelines (Bangladesh) | Cost of treatment reduced by 34%. Cost of the intervention not included. | Total drug costs for managing outpatient illness in those aged <5 years. |