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

Abstract

Background The economic benefit of the clinical pharmacist's role in ensuring the optimum use of medicines is potentially considerable, particularly when it comes to cancer management. We sought to evaluate the overall economic impact of clinical pharmacist interventions in the main cancer setting in Qatar. Methods The total economic benefit of the clinical pharmacy interventions were analyzed from the public hospital perspective. Patient records in March 2018, July/August 2018, and January 2019 were retrospectively reviewed at the National Center for Cancer Care and Research, Qatar. The total benefit from interventions was the total cost avoidance due to preventable adverse drug events plus any cost savings associated with therapeutic-based resource use. Sensitivity analyses confirmed the results’ robustness and increased generalizability. Results A total of 1352 interventions based on 281 patients were analyzed. The majority of the drug-related problems were related to the appropriateness of therapy, followed by dosing and administration. The total population benefit over the 3-months study period was QAR 4,879,185 (USD 1,336,763), constituting cost avoidance of QAR 4,234,012 (USD 1,160,003) and negative resource-use cost savings of −QAR 645,174 (−USD 176,760). Projected annual overall benefit was QAR 14,355,354 (USD 3,932,974). The increase in resource use with therapies was mostly because of the addition of other medications. Cost avoidance was mostly driven by recommending additional medications and discontinuation of medications. The uncertainty analysis demonstrated the robustness of outcomes. Conclusions The clinical pharmacist intervention increased resource use and its cost. In overall, however, taking avoided cost of adverse drug events in consideration, it is an economically beneficial practice in the National Center for Cancer Care and Research setting, associated with adverse drug events prevention and substantial economic benefits.

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

“…Thus, it was assumed that the cost of ADEs would be the same for all ADEs, leading to an additional two days stay in the hospital. This assumption is consistent with previous literature studies, where sensitivity analyses accounted for the uncertainty (Abushanab, Atchan, et al, 2023 ; Abushanab, Gulied, et al, 2023 ; Al-Badriyeh et al, 2023 ; Chen et al, 2017 ). In addition, a 3-month follow-up period in our study may not accurately reflect the actual economic gains throughout the whole year.…”

“…In line with our previous studies (Abushanab, Atchan, et al, 2023 ; Abushanab, Gulied, et al, 2023 ; Al-Badriyeh et al, 2023 ), to account for any potential variations in pharmacist vigilance during the institutional review process of pharmacists’ performance, the sample size included the first month after the annual staff performance evaluation in the NICU, the last month of the year before the evaluation, and a middle month of the year.…”

“…The cost of an ADE was estimated based on a conservative assumption that it would result in an additional two days of hospital stay in the corresponding unit, in accordance with relevant literature studies (Abushanab, Atchan, et al, 2023 ; Abushanab, Gulied, et al, 2023 ; Al-Badriyeh et al, 2023 ; Chen et al, 2017 ).…”

“…This study is not a comparative study, where the sample size used in similar literature studies varies based on factors such as the size of the setting and the prevalence of underlying conditions (Walsh et al, 2017 ). Local studies in Qatar (Abushanab, Atchan, et al, 2023 ; Abushanab, Gulied, et al, 2023 ; Al-Badriyeh et al, 2023 ), as well as international studies (Gallagher et al, 2014 ; Malani et al, 2013 ; Sebaaly et al), in secondary/tertiary care settings have reported sample sizes ranging from <100 to <2000, but predominantly <500. Considering the anticipated incidence of interventions in the study setting, a preliminary investigation indicated that a 3-month duration would be sufficient to include over 500 interventions for analysis.…”

“…Several studies have shown the critical role of the pharmacist in reducing medication errors, shortening the duration of stay, and minimising the overall cost in different healthcare settings, including the ICU (Arredondo et al, 2021 ; Houso et al, 2022 ; Menezes et al, 2020 ). Studies have been conducted in Qatar to assess the economic impact of pharmacists’ interventions in a general tertiary hospital (Abushanab, Atchan, et al, 2023 ), cardiology (Al-Badriyeh et al, 2023 ), and cancer care settings (Abushanab, Gulied, et al, 2023 ). These studies found that pharmacists’ interventions were associated with a positive annual total benefit, including a positive cost avoidance.…”