Evaluating a benchmarking database and identifying cost reduction opportunities by diagnosis-related group

Abstract

Pharmacy cost data from the University HealthSystem Consortium (UHC) Clinical Database for specific diagnosis-related groups (DRGs) were reviewed to assess their applicability to a university medical center and to identify opportunities to reduce costs. UHC headquarters was contacted by telephone to determine UHC's data collection methods. Pharmacy costs for DRG 302 (kidney transplant) at the University of Kansas Medical Center (KUMC) were compared with the costs shown in the UHC Clinical Database. Appropriate drug use for DRGs 302 and 480 (liver transplant) was assessed by contacting transplant pharmacists and pharmacy administrators at the five top-performing hospitals (in terms of cost per DRG) as listed in the UHC database to find opportunities for reducing pharmacy costs. KUMC's actual pharmacy costs for DRG 302 ($4635) were 46% lower than those listed in the UHC Clinical Database ($8546). There was a disparity between the amount of both intravenous immune globulin (IVIG) and lymphocyte immune globulin used by KUMC and the top- performing hospitals. Guidelines for use of IVIG, acyclovir, and azathioprine in liver transplant patients at KUMC were revised. A potential cost saving of $53,000 was identified in relation to the use of lymphocyte immune globulin in kidney transplant patients. Data in the UHC Clinical Database were not representative of pharmacy costs at a university medical center for DRG 302 (kidney transplant), overstating pharmacy costs by 46%; benchmarking was found to be a useful tool for identifying opportunities for reducing costs.