• Laleh Mahmoudi, Razieh Karamikhah, Azadeh Mahdavinia, Hasan Samiei, Peyman Petramfar, and Ramin Niknam.
• From the Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran (LM, RK, AM), Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran (HS), Department of Neurology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran (PP); and Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran (RN).
• Medicine (Baltimore). 2015 Oct 1; 94 (42): e1744.

AbstractAll around the world a few studies have been found on the effect of guideline implementation on direct medications' expenditure. The goal of this study was to evaluate cost savings of guideline implementation among patients who had to receive 3 costly medications including albumin, enoxaparin, and pantoprazole in a tertiary hospital in Shiraz, Iran.An 8-month prospective study was performed in 2 groups; group 1 as an observational group (control group) in 4 months from June to September 2014 and group 2 as an interventional group from October 2014 to January 2015.For group 1 the pattern of costly medications usage was determined without any intervention. For group 2, after guideline implementation, the economic impact was evaluated by making comparisons between the data achieved from the 2 groups.A total of 12,680 patients were evaluated during this study (6470 in group 1; 6210 in group 2). The reduction in the total value of costly administered drugs was 56% after guideline implementation. Such reduction in inappropriate prescribing accounts for the saving of 85,625 United States dollars (USD) monthly and estimated 1,027,500 USD annually.Guideline implementation could improve the adherence of evidence-based drug utilization and resulted in significant cost savings in a major teaching medical center via a decrease in inappropriate prescribing of costly medications.

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