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Turingan et al
the 3 health system entities for data availability. Finally, inpatient reimbursement was not factored into cost opportunity.
With the results of this study combined with current
guideline use, the health system seeks to support the development of policies to guide appropriate inpatient utilization
of bevacizumab, trastuzumab, and rituximab. Changes to
health-system formularies take significant effort over a long
period of time while expenditures continue to rise. It is
important to recognize that despite identification of opportunities to shift, the consequences are impacted immediately.
Institutions will need to take this into account when beginning to evaluate opportunities.

Conclusion
Drug expenditure related to the change in the Genentech distribution model for bevacizumab, trastuzumab, and rituximab
increased by approximately $1.4 million for the health system.
The opportunity cost of shifting inpatient administrations of
bevacizumab, trastuzumab, and rituximab for the 3 health-system entities during the study period is approximately $1.7 million. Thus, in the study period, the opportunity cost of $1.7
million to shift infusions from inpatient to outpatient can offset
the increase in expenditure due to the distribution model change.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.

Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.

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Table of Contents for the Digital Edition of Hospital Pharmacy - June 2017