Costs clinical pharmacy services, evaluations

Improving pharmacy services Decentralized pharmacy services Patient education programs Cost-justifying clinical pharmacy services Missing dose evaluation... 

Economic evidence supporting the practice of pharmaceutical care is sub-stantial. An evaluation of care delivered by pharmacists in a variety of health care settings reported an average benefit of 16.70 of value to the health care system realized for each 1 invested in clinical pharmacy services. In the Minnesota Pharmaceutical Care Project, there was a bene-fit-to-cost estimate of 11 for every 1 invested. ... 

In the time that has passed since the original ACCP prospectus, the literature has continued to grow in both depth and breadth of evidence supportive of the financial justification of clinical pharmacy services. New service models and philosophies of practice have developed in the past 6 years, the most notable being that of pharmaceutical care. " In addition, our ability to evaluate scientifically and measure the impact of clinical services on costs and outcomes has matured with the increased understanding and use of analytical techniques in health economics and pharmacoeconomics. " The effect of these advances on the quality and quantity of literature is unknown. The ACCP Board of Regents thus asked the ACCP Publications Committee to update this prospectus. 

Commonly these articles expressed net savings on an annual basis or for the time period of the study. For example, a study in 1992 described annual net cost savings of 221,056 for clinical pharmacy services provided in an ambulatory care clinic. It did not, however, include a control group. In other cases, savings were expressed per patient admission or per patient-day. In 1993, a well-conducted and controlled evaluation described an average net savings of 377 per patient admission as a result of clinical pharmacists assigned to selected inpatient medical services. 

University hospital Pharmacotherapeutic monitoring To evaluate impact of clinical pharmacy service on hospital costs using cost-benefit analysis 1.08 1 and 1.59 1... 

Despite the limitations of many of the articles as true economic evaluations, this literature contains a wealth of information pertinent to the clinical practice of pharmacy that serves to document innovative and successful experiences and programs. Of importance, we did find that when studies were well conducted (considered true economic evaluations), the results were likely to be favorable that is, the studies were able to demonstrate net savings or positive benefit cost ratios. Because of lack of standardization in reporting of results and variability in study design, it is difficult to make a general statement as to the degree of benefit derived from clinical pharmacy services. However, we were able to abstract calculated benefit cost ratios from the seven applicable studies and describe a range of value from 1.08 1 to 75.84 1 (mean 16.70 1). In other words, for every... 

It is hoped that the data summarized in this article will assist individual pharmacists, departmental managers, and health system administrators to document and recognize the cost effectiveness of pharmacists clinical services. Pharmacy practitioners should take pride in both the quantity and strength of this literature, and feel empowered to use it to justify further expansion or refinement of their caregiving responsibilities. Attention to our recommendations regarding the design and performance of future economic evaluations of clinical pharmacy services will further add to the strength of this literature and the conclusions that may be drawn from it. 

ChI 81 To evaluate clinical pharmacy services and determine cost savings and justification for additional pharmacy staff COD None Personnel costs DCA Annual net savings 25,862 ... 

To evaluate cost impact of implementing clinical pharmacy services in intensive care unit... 

CHt401 To evaluate impact of comprehensive clinical pharmacy services on hospital costs OA Pre/post None DCA Net cost savings 34.10/RPh-day Input costs not considered clinical outcomes not considered... 

Idoate, A. Ortega, A. Carrera, F.J. Aldaz, A. Giraldez, J. Cost-evaluation model for clinical trials in a hospital pharmacy service. Pharm. World Sci. 1995, 17, 172-176. 

It is important to define the reimbursment process for providing the investigational drug services. There are two main procedures a fixed reimbursement per trial for traditional services and a variable reimbursement estimated per clinical trial for other services and a fee structure (fixed and variable) in which each activity involved in a clinical trial is detailed. In our case, we use the first procedure because of its simplicity. Nevertheless, a new fee questionnaire describing the cost of each pharmacy-related activity is under evaluation. 

---