Financial impact of medication reviews by clinical pharmacists to reduce in-hospital adverse drug events: a return-on-investment analysis

Article Article scientifique Article Financial impact of medication reviews by clinical pharmacists to reduce in-hospital adverse drug events: a return-on-investment analysis eng 2024-02-05 2024-04 author Jermini Mégane 0000-0002-0748-2896 Pharmacy, Geneva University Hospitals, Rue Gabrielle Perret Gentil 4, 1205, Geneva, Switzerland. megane.jermini@hcuge.ch.,Institute of Pharmaceutical Sciences of Western Switzerland, School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland. megane.jermini@hcuge.ch. 751796 author Fonzo-Christe Caroline Cécile Pharmacy, Geneva University Hospitals, Rue Gabrielle Perret Gentil 4, 1205, Geneva, Switzerland. 501778 author Blondon Katherine Medical and Quality Directorate, Geneva University Hospitals, Geneva, Switzerland. 105577 Centre interprofessionnel de simulation (CISFM) author Milaire Christelle Finance Department, Geneva University Hospitals, Geneva, Switzerland. 403266 author Stirnemann Jérôme Division of General Internal Medicine, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland. 793435 Département de médecine (DEMED) author Bonnabry Pascal Pharmacy, Geneva University Hospitals, Rue Gabrielle Perret Gentil 4, 1205, Geneva, Switzerland.,Institute of Pharmaceutical Sciences of Western Switzerland, School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland. 21883 Section des sciences pharmaceutiques (FARMA) author Guignard Bertrand 0009-0002-4328-0375 Pharmacy, Geneva University Hospitals, Rue Gabrielle Perret Gentil 4, 1205, Geneva, Switzerland. 604263 496-505 10.1007/s11096-023-01683-w 38315303 2210-7703 PMC10960916 https://link.springer.com/article/10.1007/s11096-023-01683-w Background: Adverse drug events contribute to rising health care costs. Clinical pharmacists can reduce their risks by identifying and solving drug-related problems (DRPs) through medication review. Aim: To develop an economic model to determine whether medication reviews performed by clinical pharmacists could lead to a reduction in health care costs associated with the prevention of potential adverse drug events. Method: Two pharmacists performed medication reviews during ward rounds in an internal medicine setting over one year. 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 adverse drug events and their probabilities of occurrence for 20 randomly selected DRPs in each category. The costs of adverse drug events were extracted from internal hospital financial data. A partial economic study from a hospital perspective then estimated the annual costs avoided by resolving DRPs identified by 3 part-time clinical pharmacists (0.9 full-time equivalent) from 2019 to 2020. The return on investment (ROI) of medication review was calculated. Results: The estimated annual avoided costs associated with the potential adverse drug events induced by 676 DRPs detected was € 304,170. The cost of a 0.9 full-time equivalent clinical pharmacist was € 112,408. Extrapolated to 1 full-time equivalent, the annual net savings was € 213,069 or an ROI of 1-1.71. Sensitivity analyses showed that the economic model was robust. Conclusion: This economic model revealed the positive financial impact and favorable return on investment of a medication review intervention performed by clinical pharmacists. These findings should encourage the future deployment of a pharmacist-led adverse drug events prevention program. Adverse drug event Clinical pharmacy Cost analysis Drug related problem Economic evaluation Internal medicine Medication review Humans Pharmacists Medication Review Pharmacy Service, Hospital Drug-Related Side Effects and Adverse Reactions / epidemiology Drug-Related Side Effects and Adverse Reactions / prevention & control Hospitals Dewey 615 Dewey 616 31 Section des sciences pharmaceutiques 17 56 Département de médecine 221 false 319 Groupe Perrier Arnaud (Médecine interne générale, de réhabilitation et de gériatrie) 585 887 Pharmacie hospitalière et clinique International journal of clinical pharmacy 46 2 8bd49536-10f4-4ece-a114-f4007f4d0817 Article (Published version) Public Article_scientifique_from_europePmc.pdf 805320 application/pdf CC BY-4.0 3f29bf51c1bbe5bc9c0996d1a47a5543b44309687be6ec68faff9a67da59f127 881acb91-d7c4-40fc-904f-b4d1ea65a1f4 Appendix Public 11096_2023_1683_MOESM1_ESM.docx 31489 application/vnd.openxmlformats-officedocument.wordprocessingml.document 9fd96467a79952d67aa9c8c67aa3a6a86f1431e92e2cc637ed5ce3ffe02152f4 229e1ef1-7668-4a76-819e-73f9ca09b0bb Appendix Public 11096_2023_1683_MOESM2_ESM.docx 21037 application/vnd.openxmlformats-officedocument.wordprocessingml.document cf86513cf5c0ffef401fc385de0b78a9c1573d65089af520b64288af1cecc8a0 openAccess Faculté des sciences / Section des sciences pharmaceutiques Faculté de médecine / Section de médecine clinique / Département de médecine

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Financial impact of medication reviews by clinical pharmacists to reduce in-hospital adverse drug events: a return-on-investment analysis	International journal of clinical pharmacy			2024	126	375

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Milaire, Christelle