a RECENT investigation into supply versus demand for digoxin antidote Digoxin-Fab in NSW hospitals has revealed high levels of wastage thanks to its high cost and short shelf life.
The team from NSW Poisons Information Centre noted that demand for Digoxin-Fab decreased following the updated Therapeutic Guidelines dosing recommendations introduced in Aug 2020, which endorsed a more conservative dosing strategy.
"It is important to investigate whether NSW hospitals have adjusted their Digoxin-Fab stocking practices accordingly," they wrote in Emergency Medicine Australasia, observing also that there are no formal stocking guidelines in NSW.
Over the five-year study period, the team identified 144 cases of chronic digoxin poisoning and 16 acute cases.
In comparing hospitals' supply inventory with need for the drug, they found in some cases there were hospitals with up to 36 vials in stock - at a cost of $2,650 each - but no cases needing it.
On the other hand, there were two hospitals that needed it but did not have it on hand.
"Our findings indicate that while Digoxin-Fab is unevenly distributed across NSW hospitals, the overall supply far exceeds actual demand," they wrote.
"These results support the rationalisation of Digoxin-Fab stocking practices based on emergency department role delineation levels.
"Implementing this approach can ensure that patient safety is maintained while promoting cost-effectiveness and reducing waste in the healthcare system."
Study details are HERE.
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