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Antibiotics 2016, 5(1), 2;

Cost Reduction of Inhaled Tobramycin by Use of Preservative-Free Intravenous Tobramycin Given via Inhalation

Department of Pharmacy, Miami Veterans Affairs Healthcare System, 1201 NW 16th Street, Miami, FL 33125, USA
Department of Pharmacy, University of Minnesota Medical Center, 420 Delaware Street, Minneapolis, MN 55455, USA
College of Pharmacy, Nova Southeastern University, 11501 North Military Trail, Palm Beach Gardens, FL 33410, USA
Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, 2101 NW 117th Avenue, Miami, FL 33172, USA
Department of Pharmacy, Jackson Memorial Hospital, 1611 NW 12th Avenue, Miami, FL 33125, USA
These authors contributed equally to this work.
Author to whom correspondence should be addressed.
Academic Editors: Angela Huang and Christopher Butler
Received: 22 September 2015 / Revised: 4 December 2015 / Accepted: 23 December 2015 / Published: 29 December 2015
(This article belongs to the Special Issue Antimicrobial Stewardship)
Full-Text   |   PDF [473 KB, uploaded 29 December 2015]   |  


This study evaluates drug cost outcomes related to automatic therapeutic substitution of branded tobramycin solution for inhalation (TOBI®) with inhaled generic preservative-free intravenous tobramycin (PFIT). A retrospective single-center evaluation of inhaled tobramycin use from 2008 through 2012 was performed. Number of doses dispensed and acquisition costs were obtained. Hourly wage data was acquired, pharmacy production costs were estimated and total cost-savings calculated. Days of therapy (DOTs) were determined for each year. Quality assurance and safety data was collected. In 2008, TOBI® drug costs and doses dispensed were $118,665 and 1769, respectively. Following implementation of the interchange in May 2009, TOBI® utilization ceased. PFIT costs in 2010 through 2012 averaged $34,775 annually and TOBI® cost-avoidance exceeded $94,000 annually when accounting for pharmacy production costs, which were determined to be at most $5.28 per dose. The maximum estimated pharmacy production cost ranged from $8812 to $11,299 annually. PFIT doses dispensed exceeded 1650 each year and annual DOTs ranged from 815 to 1069. The 40-month savings were calculated to be $374,706. Quality assurance and safety data identified one patient who refused PFIT due to odor complaints and one patient who was inappropriately administered a dose orally. Therapeutic substitution of TOBI® with PFIT can produce immediate and sustained savings with an acceptable safety profile. View Full-Text
Keywords: inhaled antibiotics; pharmacy; pharmacotherapy inhaled antibiotics; pharmacy; pharmacotherapy

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Gauthier, T.P.; Wasko, J.; Unger, N.R.; Abbo, L.M.; Fernandez, M.; Aragon, L. Cost Reduction of Inhaled Tobramycin by Use of Preservative-Free Intravenous Tobramycin Given via Inhalation. Antibiotics 2016, 5, 2.

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