Economic value, of clinical pharmacy services

Willett MS, Bertch KE, Rich DS, Ereshefsky L. 1989-Prospectus on the economic value of clinical pharmacy services. Pharmacotherapy 9 45. 

In 1989, the American College of Clinical Pharmacy (ACCP) published a position statement entitled Prospectus on the Economic Value of Clinical Pharmacy Services. The document summarized literature published prior to 1988 that supported the economic value of clinical pharmacy services and as such provided a resource to the profession in efforts to advance the clinical practice of pharmacy. A similar review was pub-... 

The conclusions drawn from our review and evaluation of literature assessing the economic value of clinical pharmacy services published from 1988-1995 are multifocal. The total number of articles published on this topic has grown, as demonstrated by the number in this review (104, average 13/yr) versus the original prospectus (58, average 4/yr), which included articles published from 1974-1987. Although the number of published articles on this topic appears sufficient, an opportunity does exist for improvement in the quality of study design. 

We undertook this review and evaluation with the intent of providing the reader a resource to access original literature published assessing the economic value of clinical pharmacy services, and to evaluate the quality of that literature. The articles included in this review represent only those published in standard literature. We did not consider unpublished studies and therefore our results may be subject to inherent publication bias (so-called file drawer effect). We included only articles that contained some consideration of the financial impact of clinical pharmacy services. Certainly, many useful articles describe and evaluate clinical pharmacy services, but focus on nonfinancial outcomes and impact, and are worthy of review. Finally, our review of the literature, although intended to be systematic and thorough, may not have captured all the published literature on this topic. 

Appendix 1 Evaluations of economic value of clinical pharmacy services—1988-1995 Objective... 

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. ... 

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... 

The hospital is located in a town of approximately 100,000 people, and a large portion of the population is elderly. Partly because of both the favorable payer mix (mostly Medicare) and the fiscal savvy of the chief financial officer (CFO),1 the hospital has done very well from clinical and economic perspectives. The pharmacy department has a good drug distribution system and a director of pharmacy (DOP) who, while not trained clinically understands the value of these services. 

Quality patient care must not be compromised while attempting to contain costs. The products and services delivered by today s health professionals should demonstrate pharmacoeconomic value, that is, a balance of economic, humanistic, and clinical outcomes. Pharmacoeconomics can provide the systematic means for this quantification. This chapter discusses the principles and methods of pharmacoeconomics and how they can be applied to clinical pharmacy practice and thereby how they can assist in the valuation of pharmacotherapy and other modalities of treatment in clinical practice. 

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