Financial Impact of Medication Reviews by Clinical Pharmacists to Reduce In-Hospital Adverse Drug Events: A Return-on-Investment Analysis

Abstract

AbstractBackgrounds:Adverse drug events (ADEs) contribute to rising healthcare costs. Clinical pharmacists can reduce the risks of ADEs by preventing medication errors (MEs) through drug therapy optimization.Aim:To build an economic model to reveal whether clinical pharmacists’ medication review (MR) activities were compensated by a reduction in healthcare costs associated with the prevention of potential ADEs.Method:Pharmacists performed MR by solving drug-related problems (DRPs) to prevent ADEs during ward rounds in an internal medicine setting. First, avoided costs were estimated by monetizing five categories of DRPs (improper drug selection, drug interactions, untreated indications, inadequate dosages, and drug use without an indication). An expert panel assessed potential ADEs and their probabilities of occurrence for 20 randomly selected DRPs in each category. The costs of ADEs were extracted from internal hospital financial data. Second, a partial economic study in a hospital perspective, estimated the annual costs avoided through ADE prevention and the return on investment (ROI) of MR.Results:The estimated annual cost avoided of the potential ADEs resulting from 676 DRPs detected was € 304,170. The cost of a 0.9 full-time equivalent (FTE) clinical pharmacist was € 112,408. Extrapolated to 1 FTE, the net saving per annum was € 213,069 or an ROI of 1 to 1.71. Sensitivity analyses showed the robustness of the economic model.Conclusion:This economic model enabled to show the positive financial impact and favourable ROI of a MR intervention performed by clinical pharmacists. It should encourage the future deployment of a pharmacist-led ADE-prevention program.