Clinical and economic impact of pharmacist interventions in an ambulatory hematology–oncology department

Abstract

<jats:sec><jats:title>Objectives</jats:title><jats:p> To evaluate clinical and financial impact of pharmacist interventions in an ambulatory adult hematology–oncology department. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> All cancer patients receiving a first injectable immuno- and/or chemotherapy regimen were included in this prospective study over a one-year period. The clinical impact of pharmacist interventions made by two clinical pharmacists was rated using the Clinical Economic and Organizational tool. Financial impact was calculated through cost savings and cost avoidance. Main results: Five hundred and fifty-eight patients were included. A total of 1970 pharmacist interventions were performed corresponding to a mean number of 3.5 pharmacist interventions/patient. The clinical impact of pharmacist interventions was classified as negative, null, minor, moderate, major and lethal in 0, 84 (4%), 1353 (68%), 385 (20%), 148 (8%) and 0 cases, respectively. The overall cost savings were €175,563. One hundred and nine (6%) of all pharmacist interventions concerned immuno- or chemotherapy regimen for cost savings of €148,032 (84% of the total amount of cost savings). The cost avoidance was €390,480. Cost avoidance results were robust to sensitivity analyses with cost of preventable adverse drug event as main driver of the model. When the cost of employing a pharmacist was subtracted from the average yearly cost savings plus cost avoidance per pharmacist, this yielded a net benefit of €223,021. The cost–benefit ratio of the clinical pharmacist was €3.7 for every €1 invested. Principal conclusions: To have two full-time clinical pharmacists in a 55-bed ambulatory adult hematology–oncology department is both clinically and financially beneficial. </jats:p></jats:sec>

Impact of clinical pharmacy in oncology and hematology centers: A systematic review

“…In addition, three studies approached the humanistic impacts 20–22 and two of them discussed the economic impacts of interventions carried out by pharmacists. 23,24…”

“…Two studies demonstrated that, after the introduction of Clinical Pharmacy services at Oncology and Hematology Centers, there was a significant increase in interventions to reduce medication errors, preventable adverse drug events and medication costs. In a study carried out in France 23 in 2020, the value represented by deprescriptions and exchanges for less expensive drugs was €185,508. In turn, the value represented by the addition of medicines and the replacement by more expensive ones was €9,945.…”

“…5,6,20,26,27,32 Few studies have reported the clinical outcomes of the identified DRPs, the humanistic 17,22,28 and economic outcomes. 20,21,23,24,26,28…”

International Society of Oncology Pharmacy Practitioners (ISOPP) position statement: Role of the oncology pharmacy team in cancer care

“…Studies conducted globally have confirmed the benefit of the integration of the OPT as part the MHT within a variety of settings in improving overall patient care. 22–52…”

Clinical pharmaceutical care engagement at the Department of Infectious Diseases during the first COVID-19 pandemic wave - single centre experience

“…Poskytování klinickofarmaceutické Péče na klinice infekčních nemocí během První vlny Pandemie covid-19 -zkušenost jednoho Pracoviště(11)(12)(13)(14). Poskytování lékového poradenství a optimalizace farmakoterapie je spojeno nejen s pozitivním dopadem na klinický stav pacienta, ale také dle jiných studií s finanční efektivitou zdravotní péče(15)(16). Ačkoliv se v České republice KF péče rozvíjí od roku Je velmi důležité provést další studie hodnotící nejen množství, ale také specifika nejčastějších farmakoterapeutických doporučení na území ČR, prokázat jejich využitelnost a ukotvit tak klinickou farmacii do standardní zdravotní péče.…”