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Cost effectiveness of an enteral products formulary.

The development, implementation, and resultant cost savings of a revised enteral products formulary at a 430-bed, community teaching hospital are described. In 1982, a review of the available enteral nutrition products (ENPs) was performed by the pharmacy and food service departments in conjunction with the pharmacy and therapeutics committee. Three broad categories of products were identified--intact-protein, chemically defined, and modular formulas--with 11 subgroups. Products were then evaluated for inclusion on the restricted formulary on the basis of osmolality; source, quality, and proportions of protein, carbohydrate, and fat; electrolyte, mineral, and vitamin content; and cost. Fourteen products were admitted to the restricted 1983 formulary. Previously, 20 products had been stocked by the pharmacy. Products from two subgroups, blenderized and mild-base diets, were deleted from the formulary because of cost, infrequent use, and availability of suitable alternatives. To decrease inventory carrying costs, products are stocked in vanilla or unflavored form, with flavoring packets available. Educational efforts were undertaken to increase the medical staff's awareness of the revised formulary. Within three months of implementation of the revised formulary, purchase of nonformulary items had ceased. A considerable cost savings was achieved because of the formulary.