Cost savings and cost avoidance with the inpatient clinical pharmacist interventions in a tertiary cancer care hospital

Clinical pharmacist-led medication reconciliation supplemented with medication review in admitted patients with chronic kidney disease: a cost-benefit analysis

OBJECTIVE

Chronic kidney disease (CKD) is associated with a high economic burden, which is exacerbated by the high susceptibility to drug-related problems (DRPs) in this patient population. This study aimed to evaluate the cost-benefit ratio of medication reconciliation supplemented with medication review for inpatients with CKD, compared with the absence of this intervention.

DESIGN

This was a cost-benefit analysis conducted along with a prospective interventional study.

SETTING

The study was conducted at two hospitals in Jordan between February and May 2023.

PARTICIPANTS

The prospective interventional study included 142 admitted patients with CKD.

INTERVENTIONS

Patients received medication reconciliation at admission and discharge as well as medication review throughout admission.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome measures were the net benefit and the benefit-to-cost ratio of the intervention. A cost-benefit analysis was conducted from the healthcare system perspective by assessing the cost of the service (the pharmacist time required to complete the service per patient) and the economic benefit, including total and per-patient cost savings and cost avoidance.

RESULTS

The total estimated cost of all DRPs in the absence of interventions (cost avoidance) was $83 052 (average of $585±308 per patient); among which $20 623 was attributed to medication discrepancies. The cost savings were estimated at -$467. The supplemented medication reconciliation service was estimated to cost $714. As a result, the estimated net benefit totalled $81 871, averaging $577 per patient, with a benefit-to-cost ratio of 115.7:1 over the 4-month study period.

CONCLUSIONS

Delivering a supplemented medication reconciliation service by a clinical pharmacist for patients with CKD is cost beneficial from the healthcare perspective in Jordan, an example of a low- and middle-income country. This finding further confirms the pivotal role of clinical pharmacists in multidisciplinary healthcare teams.

Clinical pharmacists' interventions for preventing adverse events in critically ill neonates in Qatar: an economic impact analysis

Objective

This study aimed to assess the overall economic impact of clinical pharmacist interventions in the neonatal ICU (NICU) in Qatar.

Methods

A retrospective review of neonates' records was performed over a 3-month duration in the NICU of Qatar to determine the total economic benefit of clinical pharmacist interventions. The total benefit of interventions was calculated by considering the cost avoidance due to preventable adverse drug events (ADEs) and the cost savings associated with the revised resource use due to interventions. Sensitivity analyses were conducted to ensure the robustness and generalizability of the results.

Results

A total of 513 interventions were analyzed, involving 150 neonates. Most of the drug-related problems were related to therapy dosing, followed by drug choice appropriateness, the addition of prophylactic treatment, and administration frequency. The overall annual benefit was estimated at QAR 4,178,352 (1,147,584), which consisted of cost avoidance of QAR 1,050,680 (USD 288,648) and an overall cost saving of QAR -6091 (USD -1673).

Conclusions

While the clinical pharmacist interventions led to increased resource utilisation and associated costs, when considering the avoided costs of ADEs, the overall clinical pharmacist practices in the NICU setting were economically beneficial.