Economic value of pharmacy-led medicines reconciliation at admission to hospital: an observational, UK-based study

Abstract

ObjectiveTo describe the cost–benefits of pharmacy-led medicines reconciliation (MR) on admission by applying a theoretical model (University of Sheffield School of Health and Related Research—SCHARR model) to real-world data.MethodsThis was a retrospective, single-centre study. Setting 1000-bedded teaching hospital in London, UK. Clinical pharmacy contributions related to unintended medication discrepancies (averted preventable adverse drug events, pADEs), documented by pharmacy staff on prearranged days during 2012, were assessed for clinical significance by a panel of senior clinical pharmacists using the SCHARR model. Costs avoided were allocated according to the SCHARR model. Pharmacy staff carrying out admission MR were timed. Net cost avoidance was calculated by subtracting cost of time taken to carry out MR from the costs avoided by averting pADEs. Sensitivity analyses were carried out.Results118 pADEs averted as a result of MR were recorded over the 6 reporting days. 116 were rated for clinical significance. Gross costs avoided were £36 135–£75 249 (€44 446–€92 556). The admission MR process was timed for 48 patients. The mean time to complete MR for one patient was 14 min (range 1–40 min). The cost of carrying out one MR, based on the cost of employing a first-level post-foundation clinical pharmacist was £7.56 (€9.30). The net benefit of one MR was £34–£80 (€42–€98). The benefit:cost ratio was 5.53:1–11.51:1.ConclusionsPharmacy-led MR on admission has significant economic, as well as clinical benefits. Further work is required for full economic evaluations of MR.

Estimated Costs of Drug-Related Problems Prevented by Pharmacist Prescription Reviews Among Hospitalized Internal Medicine Patients

“…This ratio is lower than the ratio of 33.3, the highest ratio reported by a French study in 2013 about pharmacy services between 1999 and 2019. 30 However, our ratio is higher than 5.09, which is the ratio for a prescription review in an intensive care unit at a French hospital. 31 Another study reported a benefit-cost ratio of 1.12 to 8.73 for an outpatient PPR in 2011-2016 in a Chinese hospital.…”

Introduction of an Ambulatory Care Medication Reconciliation Service in Dialysis Patients: Positive Impact on Medication Prescribing and Economic Benefit

“…They found that medication cost reduction from MedRec service (€96.65/patient) compensated the labor costs at 6-month extrapolation by €55.62 per patient. Moreover, several studies have concluded that implementing a pharmacist-led MedRec service had higher economic value compared with usual care 5,20,21 . These findings provide insight for healthcare providers and payers on the economic benefit and importance of implementing MedRec.…”

“…Moreover, several studies have concluded that implementing a pharmacist-led MedRec service had higher economic value compared with usual care. 5,20,21 These findings provide insight for healthcare providers and payers on the economic benefit and importance of implementing MedRec.…”

Effect of educational intervention on medication reconciliation practice of hospital pharmacists in a developing country - A non-randomised controlled trial

“…A potential net cost bene t of 103 euros per patient was reported by another study done in the Netherlands [18]. Another study carried out in the United Kingdom reported up to 80 pounds cost saving on preventable adverse drug events per patient for medication reconciliation carried out [19]. These studies [17, 18,19] and others have shown that pharmacists take more detailed medication history [20][21].…”

“…Another study carried out in the United Kingdom reported up to 80 pounds cost saving on preventable adverse drug events per patient for medication reconciliation carried out [19]. These studies [17, 18,19] and others have shown that pharmacists take more detailed medication history [20][21]. The value of inclusion of pharmacists in medication reconciliation processes in acute care setting has been established by several studies [22].…”