Managing Pharmaceutical Costs. Establishing and Utilizing A Centralized Pharmacy Program. Susan M. Shields, RPh Pharmacy Director, Iowa DOC Susan.Shields@iowa.gov Harbans Deol, DO, PhD Medical Services Director, Iowa DOC Harbans.Deol@iowa.gov. Objectives:.
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Establishing and Utilizing
A Centralized Pharmacy Program
Fort Dodge Correctional Facility
Institution for Women
Iowa Medical and Classification Center
Mt. Pleasant Correctional Facility
Clarinda Correctional Facility
Iowa State Penitentiary
Des Moines Central Pharmacy
IMCC Central Pharmacy
Providing professional services while maintaining a cost-effective correctional pharmacy department:
A significant challenge.
IDOC in 2007:
9 Correctional Facilities
On-site pharmacies for 5 locations;
Off-site contract provider for 4 locations.
Offender population decreasing, Pharmaceutical expenses increasing:
FY 2007 $8,606,402 Offender Average 8780
FY 2008 $6,237,738 Offender Average 8751
FY 2009 $8,475,163 Offender Average 8605
FY 2010 $14,688,082 Offender Average 8399
Something needed to be done.
on-site, some facilities utilizing contract provider;
2. Replace contract provider with on-site pharmacies for all locations;
3. DEVISE A NEW ALTERNATIVE.
The IDOC Central Pharmacy Project
Costs FY’10 $14,688,081 Offenders 8399
Fiscal 2011--Central Pharmacy, three on-site pharmacies, and the contract provider for part of the year, all included in IDOC drug costs:
Costs: $8,567,815.63 Offenders 8897
**5.9% more offenders**
**41% less drug cost**
Costs $6,487,976 Offenders 8526
**24% less than FY 2011**
The savings continue:
Costs $5,505,871 Offenders 8256
**15% lessthan Fiscal 2012**
FY 2007 $8,606,402 Shared DOC/Contract provider
FY 2008 $6,237,738 Shared DOC/Contract provider
FY 2009 $8,475,163 Shared DOC/ Contract provider
FY 2010 $14,688,082 Shared DOC/Contract provider
FY 2011 $8,567,815 Shared DOC/Contract provider
**FIRST YEAR OF CENTRAL PHARMACY**
FY 2012 $6,487,976 DOC only
FY 2013 $5,505,871 DOC only
But even if the savings slow or stop, this project has produced three years of substantially decreased costs where increasing expenses
are more common and we have
evidence-based results that we can present to
our Governor and Legislature to show the
effectiveness of the process.
Des Moines Central: Iowa Medical & Classification Center:
FDCF, NCCF, ICIW IMCC, ASP, ISP, MPCF
Fort Dodge Correctional Facility--DOC Central Pharmacy (2010)
Penitentiary—IMCC Pharmacy (2011)
Correctional Facility—DOC Central Pharmacy (2010)
Institution for Women—DOC Central Pharmacy (2010)
Iowa Medical and Classification Center—IMCC Pharmacy (2011)
Correctional Facility--DOC Central Pharmacy (2010)
Mt. Pleasant Correctional Facility—IMCC Pharmacy (2012)
Clarinda Correctional Facility—DOC Central Pharmacy (2012)
Iowa State Penitentiary—IMCC Pharmacy (2011)
Reorganization into two pharmacies allows us to make many organizational changes that facilitate cost savings:
Our electronic medical record and pharmacy software, ICON Medical/Pharmacy, has been one of the major reasons for the IDOC’s success with its Health Care Department, including the Central Pharmacy. Anyagency that is considering whether an electronic medical record and/or CPOE pharmacy software is worth it—absolutely. The amount of time it saves by eliminating paperwork, transcription issues, and other manual entry problems and the benefits it provides in reducing the potential for errors more than justifies the cost.
Many of these recommendations can be made to work for ANY department, no matter what size.
Large Size Locations
Increasing numbers of aging patients;
Increasing numbers of mentally ill patients;
Emphasis on chronic disease management .
Maintaining cost-effective departments without compromising offender health care.
The processes used by the Iowa DOC have successfully accomplished this, and we believe they can be used by other departments to do the same.
Thank you for your attention!