The Cost of Neuromuscular Blockers in Operations of Variable Length in Turkey

Guvenc Kockaya*, 1, Pınar Daylan Kockaya2, Albert Wertheimer3
1 General Directorate of Pharmaceuticals and Pharmacy, Pharmacoeconomy Departmen,
2 Polatlı Duatepe Goverment Hospital, Turkey
3 Temple University, School of Pharmacy, Center for Pharmaceutical Health Services Research, Turkey

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© Kockaya et al.;

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Sogutozu M. 2176. Sok. N:5 K:9 Cankaya, Ankara, Turkey Tel: + 90 544 795 0880; E-mail:


Decision makers develop new strategies to minimize the anesthetic costs and maintain the quailty of health care. The aim of our study is to help decision makers, in Turkey, in developing new strategies to minimize anesthetic costs. Three different operational strategies were assumed. The first strategy was for operations under 30 minutes; the second strategy was for operations between 30 and 60 minutes and the third strategy was for operations above 60 minutes. Neuromusculer blocker cost by milligram per kilogram was calculated for each operation strategy. Atracurium had the lowest per milligram cost (US$0.08), followed by rocuronium (US$0.09), mivacurium (US$0.38), vecuronium (US$0.44) and cisatracurium (US$0.59). Atracurium and vecuronium had the lowest costs in operations which are under 30 minutes, followed by rocuronium, mivacurium and cisatracurium. Vecuronium had the lowest costs in operations which are 30-60 minutes, followed by atracurium, rocuronium and cisatracurium. Vecuronium which had the lowest costs in operations above 60 minutes, followed by atracurium, rocuronium and cisatracurium. The managements of hospitals or hospital groups which are in Turkey can choose atracurium and vecuronium in operations under 30 minutes, vecuronium in operations 30-60 minutes and above 60 minutes in their neuromuscular blocker (NMB) formularies for making cost reductions from NMBs.

Keywords: Neuromuscular blocker agents, economics, hospital costs..