Cost of anaesthetic drugs and clinical budgeting

In 1980 Astley and Secker Walker calculated that the average total cost to the National Health Service of one anaesthetic was £29-98.' The cost of drugs for the year 1979-80 was £44 032 or 8 6% of the total hospital cost of anaesthesia of £506 459. This paper examines the drugs bill for the University College Hospital group of hospitals between April 1984 and March 1985 and compares it directly with the study of the drugs bill for 1979-80.' It highlights the financial consequences of changes in anaesthetic practice. We have also examined the cost of anaesthesia for one hour in 1985 and compared it with the cost ofanaesthesia for the same operation (hysterectomy) lasting one hour in 1980. This shows how the choice of the newer anaesthetic drugs in 1985 led to a rise in costs, when compared with 1980, which is above the percentage rise of the Retail Price Index. Medical and nursing staff salaries account for 83% of the cost of anaesthesia, but the cost of anaesthetic drugs is the next most important factor. Ifthe drugs bill were allowed to rise faster than the annual increase for inflation in the departmental budget it would be necessary to make equivalent economies elsewhere in the anaesthetic department's budget.