Cost-benefit analysis of pharmacist interventions over 36 months in a university hospital

Author(s)

Maurilio de Souza Cazarim ^[1] ; João Paulo Vilela Rodrigues ^[2] ; Priscila Santos Calcini ^[3] ; Thomas R. Einarson ^[4] ; Leonardo Régis Leira Pereira ^[5]

Affiliation

^[1] Universidade de São Paulo. Faculdade de Ciências Farmacêuticas de Ribeirão Preto - Brasil

^[2] Universidade de São Paulo. Faculdade de Ciências Farmacêuticas de Ribeirão Preto - Brasil

^[3] Universidade de Ribeirão Preto. Faculdade de Ciências Farmacêuticas - Brasil

^[4] University of Toronto. Leslie Dan Faculty of Pharmacy - Canadá

^[5] Universidade de São Paulo. Faculdade de Ciências Farmacêuticas de Ribeirão Preto - Brasil

• Document type: Journal article
• Source: Revista de Saúde Pública; v. 54, 2020-09-30.

Abstract

ABSTRACT OBJECTIVE: To perform a cost-benefits analysis of a clinical pharmacy (CP) service implemented in a Neurology ward of a tertiary teaching hospital. METHODS: This is a cost-benefit analysis of a single arm, prospective cohort study performed at the adult Neurology Unit over 36 months, which has evaluated the results of a CP service from a hospital and Public Health System (PHS) perspective. The interventions were classified into 14 categories and the costs identified as direct medical costs. The results were analyzed by the total and marginal cost, the benefit-cost ratio (BCR) and the net benefit (NB). RESULTS: The total 334 patients were followed-up and the highest occurrence in 506 interventions was drug introduction (29.0%). The marginal cost for the hospital and avoided cost for PHS was US$182±32 and US$25,536±4,923 per year; and US$0.55 and US$76.4 per patient/year. The BCR and NB were 0.0, -US$26,105 (95%CI −31,850 − –10,610), -US$27,112 (95%CI −33,160–11,720) for the hospital and; 3.0 (95%CI 1.97–4.94), US$51,048 (95%CI 27,645–75,716) and, 4.6 (95%CI 2.24–10.05), US$91,496 (95%CI 34,700–168,050; p < 0.001) for the PHS, both considering adhered and total interventions, respectively. CONCLUSIONS: The CP service was not directly cost-benefit at the hospital perspective, but it presented savings for forecast cost related to the occurrence of preventable morbidities, measuring a good cost-benefit for the PHS. (AU)

• FAPESP's process: 16/03584-1 - DEVELOPMENT AND VALIDATION OF A PHARMACOECONOMIC TOOL FOR THE IMPLEMENTATION OF PHARMACEUTICAL CARE FOR HYPERTENSIVE PATIENTS IN THE PUBLIC HEALTH SYSTEM OF BRAZIL
• Grantee: Maurilio de Souza Cazarim
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 17/21240-0 - Development and validation of a pharmacoeconomic tool for decision making in the implementation of pharmaceutical care for hypertensive patients in the public health system
• Grantee: Maurilio de Souza Cazarim
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate