Strategies of drugs cost containment in hospital: A systematic literature review

Mohammad‐Saleh Koushki, Reza Goudarzi, Mohammadreza Amiresmaili, Mahmoud Nekooei Moghaddam, Vahid Yazdi‐Feyzabadi and Ali Talebian

International Journal of Health Planning and Management, 2023, vol. 38, issue 1, 7-21

Abstract: Background In recent years, the world's health system faces with increasing trend of costs. In this regard, Hospital is one of the environments that consumes a large share of the total expenditure of the health system. Medications are one of the most expensive components in hospitals, which require appropriate measurements to control and reduce costs. The present systematic review was conducted to identify strategies and actions for cost containment in hospital. Method Using the PRISMA protocol, a systematic review of the texts was performed to identify strategies and actions for reducing drug cost. In this systematic review, the selected keywords were searched in the following databases: web of sciences, Scopus, PubMed, Google Scholar, and Embase. The inclusion criteria included English‐language articles, hospital‐level studies, and those studies performed on reducing and controlling hospital costs. The exclusion criteria also included the followings: primary health care studies, non‐English language studies, health system studies, and studies solely focussed on the cost‐effectiveness of a particular drug. The quality of these articles was investigated using the checklist adapted and modified in the present study. Results A total of 4696 articles were identified from the reviewed databases and 26 articles were identified from some other sources. After removing duplicate studies and reviewing the title, summary, and full text of articles using reference check and supplemental search, 21 articles were finally included. A number of strategies or managerial actions were extracted from the final articles. According to the qualitative results, qualitative meta‐synthesis was used and after eliminating duplicate solutions, the data were classified into five groups: procurement, storage, distribution, prescription, and use. Conclusion According to the increasing cost of medicines, some hospital managers now attempt to reduce hospital costs using drug chain management. Drug cost reduction strategies can be applied for any component of drug chain management such as procurement, storage, distribution, prescription, and use. Also, proper implementation of these strategies and rationalisation of drug use will result in more efficiency of the hospital.

Date: 2023
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