Reverse auction: a potential strategy for reduction of pharmacological therapy cost

Abstract

Background: Polypharmacy is a significant economic burden.

Objective: We tested whether using reverse auction (RA) as compared with commercial pharmacy (CP) to purchase medicine results in lower pharmaceutical costs for heart failure (HF) and heart transplantation (HT) outpatients.

Methods: We compared the costs via RA versus CP in 808 HF and 147 HT patients followed from 2009 through 2011, and evaluated the influence of clinical and demographic variables on cost.

Results: The monthly cost per patient for HF drugs acquired via RA was $10.15 (IQ 3.51-40.22) versus $161.76 (IQ 86.05‑340.15) via CP; for HT, those costs were $393.08 (IQ 124.74-774.76) and $1,207.70 (IQ 604.48-2,499.97), respectively.

Conclusion: RA may reduce the cost of prescription drugs for HF and HT, potentially making HF treatment more accessible. Clinical characteristics can influence the cost and benefits of RA. RA may be a new health policy strategy to reduce costs of prescribed medications for HF and HT patients, reducing the economic burden of treatment.

Figure 1

Percentage cost reduction in delivered prescription drugs purchased via reverse auction in comparison with private costs according to each drug group in heart failure (Top) and heart transplantation (Bottom). Immunosup: immunosuppressants; ONCD: other noncardiovascular drugs; CCB: calcium channel blockers; ACEI: angiotensin-converting enzyme inhibitors; ARB: angiotensin receptor blockers; OCD: other cardiovascular drugs; Antiplatelet: antiplatelet drugs; ACG: anticoagulants; IPADPR: inhibitors of platelet adenosine diphosphate receptor.

Figure 2

Cost of delivered prescription drugs purchased via reverse auction (RA) compared with commercial pharmacy (CP) costs according to the diagnosis of systemic arterial hypertension and diabetes mellitus in heart failure and heart transplantation.