Cost analysis before and after implementation of a computerized physician order entry order form for enoxaparin.

OBJECTIVE The authors sought to analyze the impact of a computerized physician order entry (CPOE) order form for enoxaparin sodium injection (Lovenox) to reduce the daily cost of drug therapy by switching appropriate patients to once-daily enoxaparin administration. METHODS The study population included patients older than 18 years of age who had been treated with enoxaparin from September 1 to December 31, 2008 (the pre-order form implementation group) and from March 1 to June 30, 2009 (the post-order form implementation group). The wholesale acquisition cost was used to determine the cost of enoxaparin per day. Appropriate dosing was established by chart review. RESULTS The post-implementation group showed a trend toward a higher cost of enoxaparin therapy per day compared with the pre-implementation group (P = 0.23). There was a non-significant increase in appropriate dosing after implementation of the order form-from 64.5% before implementation to 71.5% after implementation (P = 0.13). In the overall cohort, although the authors controlled for other factors that could influence cost, patients who received the appropriate dose per protocol were 3.2 times more likely (95% confidence interval, 1.8-5.9; P = 0.001) to have lower enoxaparin drug costs per day of therapy. CONCLUSION The use of a CPOE enoxaparin order form did not reduce the daily cost of therapy.