Sentara Healthcare, in Norfolk, Va., aims to shave at least 3% to 4% from its annual $160 million drug spend—with no compromise in care quality for inpatients and outpatients—by using a new analytics tool across all pharmacies in its 12 hospitals, 10 retail stores, and long-term care and home health care sites.

Since February, the health system has been using McKesson’s Drug Spend Intelligence (DSI) online tool to effectively analyze dollars spent and quantities bought by its diverse pharmacies, Eddie Gutshall, PharmD, the pharmacy business manager at Sentara, told Pharmacy Practice News.

It has, for instance, already spotlighted its 10 biggest spend increases on formulary drugs, and spawned collaborative discussions among pharmacy, the pharmacy and therapeutics committee, physicians and nurses about:

• Neostigmine, a muscle disease drug; spend for it rose 826% in one year despite 1% less utilization.
• Vasopressin, an antidiuretic; spend rose 1,700% in one year despite 18% less utilization.
• Nivolumab (Opdivo, Bristol-Myers Squibb), a cancer treatment; spend rose from $0 to $1 million in one year, and could double next year with higher physician adoption.
• Bupivacaine, a local anesthetic for knee and hip replacement surgeries; spend for it rose 268% to nearly $2 million in one year, largely reflecting 254% greater adoption by surgeons.
• Nitroprusside, an anti-hypertensive, which may soon be replaced on the formulary with less-expensive nicardipine.

Dr. Gutshall recalls how Sentara saw on a predecessor McKesson trend tool that it was spending nearly $2 million annually on intravenous Tylenol (Johnson & Johnson) at $38 per dose, then chose in 2015 to administer oral Tylenol 30 minutes before surgery instead for the same patient benefit, at just 2 cents per dose.

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