Potential cost-avoidance with oral extended-release morphine sulfate tablets versus morphine sulfate solution. 1991

B R Goughnour, and W W Arkinstall
Department of Pharmacy Services, Kelowna General Hospital, British Columbia, Canada.

The costs of acquiring, preparing, and administering morphine sulfate extended-release tablets and morphine sulfate solution were compared. Pharmacists at an acute-care community hospital timed the pharmacy and nursing components of the process of preparing and administering single doses of morphine sulfate extended-release tablets 60 mg and morphine sulfate solution 5 mg/mL. The labor cost of each step was determined by multiplying the mean time required to perform the task by the median of the wage scale for the person performing it. Acquisition costs and ancillary supply costs were determined, and the overall cost of each therapy was calculated. The total time required for providing single doses did not differ substantially. However, assuming a total daily morphine sulfate dosage of 120 mg, the time required for administering extended-release morphine sulfate tablets 60 mg twice daily was determined to be 8.90 minutes, compared with 23.44 minutes for solution (4 mL of 5-mg/mL solution) six times daily. Thus, although the cost of acquiring extended-release tablets was considerably higher than that of solution, the total daily cost of therapy with tablets was less than half that of therapy with solution. The potential for cost avoidance and the clinical advantages associated with extended-release morphine sulfate tablets make this formulation an attractive therapeutic alternative.

UI MeSH Term Description Entries
D008510 Medication Systems, Hospital Overall systems, traditional or automated, to provide medication to patients in hospitals. Elements of the system are: handling the physician's order, transcription of the order by nurse and/or pharmacist, filling the medication order, transfer to the nursing unit, and administration to the patient. Hospital Drug Distribution Systems,Hospital Medication System,Hospital Medication Systems,Medication System, Hospital,Drug Distribution System, Hospital,Drug Distribution Systems, Hospital,Hospital Unit Dose Drug Distribution System,Hospital Unit Dose Drug Distribution Systems,System Hospital Medication,Systems, Medication Hospital,Hospital Medication, System,Hospital Medications, System,Hospital System, Medication,Hospital Systems, Medication,Medication Hospital System,Medication Hospital Systems,Medication, System Hospital,Medications, System Hospital,System Hospital Medications,System, Hospital Medication,System, Medication Hospital,Systems, Hospital Medication
D009020 Morphine The principal alkaloid in opium and the prototype opiate analgesic and narcotic. Morphine has widespread effects in the central nervous system and on smooth muscle. Morphine Sulfate,Duramorph,MS Contin,Morphia,Morphine Chloride,Morphine Sulfate (2:1), Anhydrous,Morphine Sulfate (2:1), Pentahydrate,Oramorph SR,SDZ 202-250,SDZ202-250,Chloride, Morphine,Contin, MS,SDZ 202 250,SDZ 202250,SDZ202 250,SDZ202250,Sulfate, Morphine
D002626 Chemistry, Pharmaceutical Chemistry dealing with the composition and preparation of agents having PHARMACOLOGIC ACTIONS or diagnostic use. Medicinal Chemistry,Chemistry, Pharmaceutic,Pharmaceutic Chemistry,Pharmaceutical Chemistry,Chemistry, Medicinal
D003365 Costs and Cost Analysis Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs. Affordability,Analysis, Cost,Cost,Cost Analysis,Cost Comparison,Cost Measures,Cost-Minimization Analysis,Costs and Cost Analyses,Costs, Cost Analysis,Pricing,Affordabilities,Analyses, Cost,Analyses, Cost-Minimization,Analysis, Cost-Minimization,Comparison, Cost,Comparisons, Cost,Cost Analyses,Cost Comparisons,Cost Measure,Cost Minimization Analysis,Cost, Cost Analysis,Cost-Minimization Analyses,Costs,Measure, Cost,Measures, Cost
D003692 Delayed-Action Preparations Dosage forms of a drug that act over a period of time by controlled-release processes or technology. Controlled Release Formulation,Controlled-Release Formulation,Controlled-Release Preparation,Delayed-Action Preparation,Depot Preparation,Depot Preparations,Extended Release Formulation,Extended Release Preparation,Prolonged-Action Preparation,Prolonged-Action Preparations,Sustained Release Formulation,Sustained-Release Preparation,Sustained-Release Preparations,Timed-Release Preparation,Timed-Release Preparations,Controlled-Release Formulations,Controlled-Release Preparations,Extended Release Formulations,Extended Release Preparations,Slow Release Formulation,Sustained Release Formulations,Controlled Release Formulations,Controlled Release Preparation,Controlled Release Preparations,Delayed Action Preparation,Delayed Action Preparations,Formulation, Controlled Release,Formulations, Controlled Release,Prolonged Action Preparation,Release Formulation, Controlled,Release Formulations, Controlled,Sustained Release Preparation,Timed Release Preparation,Timed Release Preparations
D004339 Drug Compounding The preparation, mixing, and assembly of a drug. (From Remington, The Science and Practice of Pharmacy, 19th ed, p1814). Drug Formulation,Drug Preparation,Drug Microencapsulation,Pharmaceutical Formulation,Compounding, Drug,Formulation, Drug,Formulation, Pharmaceutical,Microencapsulation, Drug,Preparation, Drug
D006745 Hospital Bed Capacity, 300 to 499 The number of beds from 300 to 499 which a hospital has been designed and constructed to contain. It may also refer to the number of beds set up and staffed for use.
D000284 Administration, Oral The giving of drugs, chemicals, or other substances by mouth. Drug Administration, Oral,Administration, Oral Drug,Oral Administration,Oral Drug Administration,Administrations, Oral,Administrations, Oral Drug,Drug Administrations, Oral,Oral Administrations,Oral Drug Administrations
D013996 Time and Motion Studies The observation and analysis of movements in a task with an emphasis on the amount of time required to perform the task. Time Studies,Studies, Time,Study, Time,Time Study

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