Pharmacoeconomics of Intravenous Drug Administration
- First Online:
Direct administration of a drug into a vein guarantees bioavailability, i.e. the total amount of drug is fully available to the bloodstream for transport to all areas of the body. What is not ensured is the safety, need and ‘Value for money’ of this route. Few workers would disagree that there is increased morbidity associated with this method of administration. Adverse events range from the painful irritation of veins to life-threatening infection introduced by needle puncture. It is proposed that in many situations the disadvantages of the intravenous (IV) route outweigh the advantages.
There are many hidden costs of IV therapy ranging from the adverse events associated with IV administration to the need for specialised equipment, consumables and additional personnel time. Recent studies have shown that the oral route can be substituted in many patients receiving IV therapy without loss of efficacy. The reduction in costs intrinsic to IV therapy is an additional bonus.
There is a need to increase the use of alternative routes of administration on the basis of safety, quality of life and cost.
Unable to display preview. Download preview PDF.
- Baciewicz AM. Conversion of intravenous ranitidine to oral therapy. Drug Intelligence and Clinical Pharmacy 25: 251–252, 1991Google Scholar
- Bioavailability and bioequivalence requirements rules and regulations. Federal Register 42: 1643, 1977Google Scholar
- Breckenridge A. Report of the working party on the addition of drugs to intravenous fluids. DHSS, Health Circular HC (76) March 9, 1976Google Scholar
- Clark CM, Bailie GR, Whitaker AM, Goldberg LA. Parenteral drug delivery — value for money? Pharmaceutical Journal 236: 453–455, 1986Google Scholar
- Clark C. Centralised IV additive services — better control for pharmacies? British Journal of Pharmaceutical Practice 10: 502–504, 1988Google Scholar
- Cousins DH, Lee M, Stanaway M, Neary C. Implementation and evaluation of a centralised IV additive service for antibiotic injections. Pharmaceutical Journal 242 (Hospital Suppl): 14–16, 1989Google Scholar
- Davey P, Dodd T, Kerr S, Malek M. Audit of IV antibiotic administration. Pharmaceutical Journal 244: 793–796, 1990Google Scholar
- Davey PG, Parker SE. Cost effectiveness of once daily oral antimicrobial therapy. American Journal of Clinical Pharmacology, in press, 1992Google Scholar
- Leigh DA. Economic implications of oral treatment replacing parenteral therapy. 6th Medical Congress of Chemotherapy, Taormina, May 22–27, 1988. pp. 189–197, 1988Google Scholar
- Malek M, Lynch W, Wells N, Elliott T, Bint A, et al. A comparison of the costs of ceftazidime therapy and gentamicin combinations in three UK hospitals. Journal of Antimicrobial Therapy, in press, 1992Google Scholar
- Quintilliani R, Cooper BW, Briceland LL, Nightingale CH. Economic impact of streamlining antibiotic administration. American Journal of Medicine 82 (Suppl. 4A): 391–394, 1987Google Scholar
- Savitsky ME, Kirking DM, Cornish LA, Crudo DJ, Berardi RR. Costs associated with the inappropriate route of administration of parenteral histamine2-receptor antagonists. DICP: Annals of Pharmacotherapy 21: 885–889, 1987Google Scholar
- Strandvik B, Hjelte L, Lingblad A, Ljundberg B, Malmborg A, et al. Comparison of efficacy and tolerance of intravenously and orally administered ciprofloxacin in cystic fibrosis patients with acute exacerbations of lung infection. Scandinavian Journal of Infectious Diseases 60: 84–88, 1989PubMedGoogle Scholar