Emergency Department Psychiatry

A large urban hospital is having problems with bed management because of overcapacity. You are the pharmacist in the emergency department (ED). A number of patients have been coming in with acute schizophrenic conditions. They must first be stabilized before they can be transferred to the system’s psychiatric hospital. You would like to switch the antipsychotic medications being used in the ED to improve symptoms and decrease the time to stabilization so that these patients are not tying up ED beds for so long.

You are considering recommending the use of Sychout instead of Histormed.

  Symptom improvement rate Cost
Sychout 48% $22 per 10 mg injection
Histormed 30% $2 per 10 mg injection

The hospital’s average number of psychiatric ED visits is 50 per month.

  1. What type of analysis should you perform?
  2. What is the average CER for each drug?
  3. What is the ICER?
  4. What other information would you need to make an educated decision about whether to recommend the switch?
  5. What is the incremental net benefit if the hospital is willing to pay for an additional cured patient? (Calculate for λ = $5, $100, $200.)

 


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