Mohamed Ibrahim, Mohamed Izham and Ahmed Abdelrahim, Hisham Elhag and Ab Rahman, Ab Fatah
(2014)
Cost evaluation of therapeutic drug monitoring of gentamicin at a teaching hospital in Malaysia.
Pharmacy Practice, 12 (1).
pp. 1-6.
ISSN 1886-3655
Abstract
Background: Therapeutic drug monitoring (TDM) makes
use of serum drug concentrations as an adjunct to
decision-making. Preliminary data in our hospital showed
that approximately one-fifth of all drugs monitored by TDM
service were gentamicin.
Objective: In this study, we evaluated the costs
associated with providing the service in patients with
bronchopneumonia and treated with gentamicin.
Methods: We retrospectively collected data from medical
records of patients admitted to the Hospital Universiti
Sains Malaysia over a 5-year period. These patients were
diagnosed with bronchopneumonia and were on
gentamicin as part of their treatment. Five hospitalisation
costs were calculated; (i) cost of laboratory and clinical
investigations, (ii) cost associated with each gentamicin
dose, (iii) fixed and operating costs of TDM service, (iv)
cost of providing medical care, and (v) cost of hospital stay
during gentamicin treatment.
Results: There were 1920 patients admitted with
bronchopneumonia of which 67 (3.5%) had TDM service
for gentamicin. Seventy-three percent (49/67) patients
were eligible for final analysis. The duration of gentamicin
therapy ranged from 3 to 15 days. The cost of providing
one gentamicin assay was MYR25, and the average cost
of TDM service for each patient was MYR104. The
average total hospitalisation cost during gentamicin
treatment for each patient was MYR442 (1EUR approx.
MYR4.02).
Conclusion: Based on the hospital perspective, in
patients with bronchopneumonia and treated with
gentamicin, the provision of TDM service contributes to
less than 25% of the total cost of hospitalization.
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