Healthcare Quarterly

Healthcare Quarterly 16(3) July 2013 : 42-47.doi:10.12927/hcq.2013.23498
Value for Money

Piloting an Outpatient Policy for Funding Drugs and Their Administration in Rheumatology

Bernadette Chevalier, Christy Simpson, Heather Hemming, Anne Hiltz, Randi Monroe and Victoria Sullivan


To ensure appropriate use of outpatient clinic resources, an inter-professional group drafted a policy for an equitable, consistent process requiring the use of patients' drug insurance. The authors' organization remains the payer of last resort. A pilot tested and further informed this policy by targeting rituximab in rheumatoid arthritis. Staff were in-serviced, resources were arranged and patients were informed. Thirty-nine pilot patients (87%) had drug insurance, resulting in a savings of $304,700. Fifty-one hospital infusions were administered in private clinics, avoiding $19,125 in clinic costs. Patient and staff/stakeholder satisfaction surveys provided valuable feedback. Lessons learned will be applied to the policy and related processes in preparation for an organizational-wide implementation.



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