January 11, 1980

Overuse of Albumin

Author Affiliations

Veterans Administration Medical Center Roseburg, Ore

JAMA. 1980;243(2):121. doi:10.1001/jama.1980.03300280019019

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To the Editor.—  The article, "Therapeutic Use of Albumin," by Alexander et al (241:2527, 1979), emphasizes the need to control cost by physician education. The authors are to be complimented for the thoroughly detailed method they used. However, their study required a considerable investment of time and personnel before effecting a saving.I would like to share the method I used as chief of staff at the Boston Veterans Administration Hospital many years ago when faced with a similar situation.The wards were requesting serum albumin on a pharmacy order form. These ampules were then dispensed by physician order. The drug bill for the hospital was increasing by $25,000 a month before it was brought to my attention. A program was initiated immediately whereby the physician wrote a prescription for the individual patient, stating the diagnosis and the number of ampules required. This prescription had to be countersigned by the