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ARMY HEALTH SERVICES COMMAND FORMING PHARMACOECONOMIC CENTER

Executive Summary

ARMY HEALTH SERVICES COMMAND FORMING PHARMACOECONOMIC CENTER in an effort to bring soaring drug expenditures at Army medical facilities in the U.S. under better control. HSC pharmaceutical expenditures have increased from 46% to 51% of "expendable supply dollars" in the past five years. Expendable supplies include medical and surgical supplies that are used up, but not major medical equipment or payroll. HSC pharmaceutical expenditures totaled $230 mil. in FY 1992 (ended Oct. 1), a 24% increase over the $185 mil. spent in FY 1991. The pharmacoeconomic center will be located at the Brooke Army Medical Center in San Antonio and consist of 11 personnel. The center, which the Army expects will begin operating in January, will create educational programs and target specific drugs in an effort to promote cost-effective drug use in U.S. Army medical centers. HSC also is assembling 25 pharmacists who will be assigned to the Army's 25 largest U.S. hospitals to implement the pharmacoeconomic center's policies, ideas and education programs. The U.S. Health Services Command has allotted $2.3 mil. to its pharmaco-economic education push in 1993, and hopes the effort will save the Army $6.1 mil. over the same time period. The program may not lead to a decrease in the Command's pharmaceutical budget. It may even increase, provided that overall expenditures are decreased, Col. James Wilson, pharmacy consultant to the Army Surgeon General, explained. He noted that one challenge the program faces, specifically in the ambulatory care area, is finding a method to assess whether the program is saving money indirectly. The pharmacoeconomic center employees will consist of pharmacists, clerical staff and at least one full-time physician, with additional physicians acting in an advisory capacity. HSC is also considering contracting some pharmacoeconomic work from pharmacy schools, including cost effectiveness assessments of new drugs entering the market. The 25 clinical pharmacists will focus primarily on prescriber education and secondarily on pharmaceutical use in the ambulatory care setting. Most of these pharmacists will be civilians hired specifically for the job, and some will be reassigned from other Army posts.

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