Cost‐benefit of reimbursement for pharmaceutical care in Taiwan

Abstract

BackgroundPharmaceutical care provided by well‐educated clinical pharmacists improves the safety and effectiveness of health care, especially regarding medication use, and can thus save costs.AimsThe aim of this study is to illustrate the implementation of the reimbursement policy of National Health Insurance for pharmaceutical care in Taiwan, to determine its influences on current health care practices, and to evaluate the quantity of pharmacy interventions.Materials & MethodsThe inclusion criteria for this study were qualified pharmacists working in intensive care units (ICUs) at medical centers and regional hospitals or in clinics at district hospitals who provided pharmaceutical care services. Details of the pharmaceutical care they provided—including pharmacy notes (in the subjective, objective, assessment, and plan sequence), intervention type, and acceptance by physicians—were uploaded and documented via an online virtual private network platform, from which data were later collected and analyzed.ResultsDuring the first quarter of 2019, a total of 260 pharmacists were included in the analysis, 109 of whom were from medical centers, 94 from regional hospitals, and 57 from district hospitals. The total person‐days of pharmaceutical care during the study period was 12 158 for medical centers, 7090 for regional hospitals, and 757 for district hospitals. The acceptance rates of the doctors were 98.3%, 89.5%, and 90.5% for medical centers, regional hospitals, and district hospitals, respectively.DiscussionThe cost savings of pharmaceutical care was estimated by adverse drug events (ADEs) avoidance based on an average prolonged ICU stay of 2 days per ADE. Pharmaceutical care in ICUs resulted in a savings of 57 931 710 New Taiwan Dollars during the study period, with a cost‐benefit ratio of 13.7.ConculsionBased on the cost effectiveness of pharmaceutical care in early 2019, the program should be reserved and expanded to different settings, and it will hopefully become an essential service provided by pharmacists in Taiwan.