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Evidence of the Value of the Pharmacist Pharmacists Impact on This document summarizes Health Care Cost and key studies that demonstrate the Quality Study Citation broad range of pharmacist- Pharmacists providing asthma 1The Asheville Project. Pharmacy provided patient care services management services and Times. Romaine Pierson Publishers, that have resulted in: pharmaceutical care to two Inc. Westbury:NY. October 1998. Bunting B. (excerpt) Asheville employers decreased cost,• Improved Disease & Drug Therapy Management improved care, and improved Project Continues to Produce Positive Results. Americas • Greater Patient Satisfaction work absence rates. Pharmacist. May 2000:43-44 • Improved Quality of Life • Significant Cost Containment and Savings This study shows that costs 2Ernst FR, Grizzle, AJ. Drug-Related associated with drug-related Morbidity and Mortality: Updating problems in the US exceeds the Cost-of-Illness Model. Journal of $177 billion - more than the the American Pharmaceutical cost of the drugs themselves. Association. 2001: Mar-Apr; 41(2):192-199 In a study evaluating the effect ofpharmacists providing pharmaceutical care 3Knapp KK, Katzman H, Hambright Pharmacists providing services services on the economic outcomes of for an HMO to patients in their JS et al. Community pharmacist patient care, an average benefit of community saved an average of interventions in a $20 per prescription. capitated pharmacy benefit$16.70 of value to the health care system contract. American Journal of was realized for each $1 invested in Health-System Pharmacy. 1998; clinical pharmacy services. 55(11):1141-5 This benefit was observed in a variety of Pharmacists providing 4Bluml BM, McKenney JM, Cziraky health care settings (community, government, pharmaceutical care to patients MJ. Pharmaceutical care services and university hospitals; clinic settings) and with high cholesterol in their and results in Project ImPACT: included drug dosing and drug therapy community improved patient Hyperlipidemia. Journal of the compliance with medication American Pharmaceutical management services provided by pharmacists. from a national average of Association 2000;40(2):157-165 40% to 90%. Pharmacists providing 5The Fleetwood Project, American Over 20 studies and demonstration projects pharmaceutical care services to Society of Consultant Pharmacists patients in long-term care confirm that pharmacists add value to the facilities increased the number health care system by improving care and of patients receiving optimal care by 45% - resulting in an decreasing cost. estimated $3.7 billion in cost avoidance. More inside
Evidence of the Value of the PharmacistPharmacists Impact onHealth Care Cost andQuality Study CitationPharmacists providing 6Hatoum HT, Witte KW, Hutchinson During a 6-month period, pharmacistspharmaceutical care to RA. Patient care contributions of clinical pharmacists in four joined doctors, residents, and otherpatients in an ambulatorycare clinic saved nearly ambulatory care clinics. Hospital members of the patient care team on$250,000 in one month. Pharmacy. 1992; 27(3): 203-6, 208-9 patient rounds in the intensive care unit at a large, urban teachingPharmacist services provided in 7Dobie RL, Rascati KL. Documenting hospital.community pharmacies saved the value of pharmacistapproximately $3.47 per interventions. American Pharmacy.prescription. 1994; May; NS34(5):50-4 Results showed:Pharmacists working with 8Forstrom MJ, Ried LD, Stergachis AS • Preventable adverse drug eventspatients with high blood et al. Effect of a clinical pharmacist decreased by 66%. pressure in an HMO family program on the cost of hypertension • A projected $270,000, related to adversepractice saved $20.61/patient treatment in an HMO family practice drug events, could be saved annually.in drug costs and decreased clinic. Annals of Pharmacotherapy. • 366 of the 400 pharmacist interventionsthe number of drugs 1990; 24(3):304-9 were related to medication errors.prescribed. • Pharmacist interventions helped prevent 9Jameson J, VanNoord G, incomplete orders, incorrect dosages andPharmacists collaborating with frequency, less-than-optimal drug choices, Vanderwoud K. The impact of thephysicians to care for high-risk pharmacotherapy consultation on the and duplicate prescriptions.patients reduced the number cost and outcome of medical therapy.of prescriptions per patient Journal of Family Practice. 1995;and saved nearly $600 per year Nov.; 41(5):469-72per patient in drug costs. 10Munroe WP, Kunz K, Dalmady- Pharmacists working in theirPharmacists providing disease Israel C et al. Economic evaluation of communities produced a 74%management services in their pharmacist involvement in disease increase in vaccination rates bycommunity saved an average management in a communityof $2700 per year per patient advising high-risk patients of pharmacy setting. Clinicalin total medical costs. Therapeutics. 1997; 19(1):113-23. infection risk and describing where to go to be vaccinated.Pharmacists providing 11Schumock GT, Meek PD, Ploetz PA,pharmaceutical care services Patient acceptance was excellent, Vermeulen LC. Economic evaluationsgenerate a return-on- with pharmacists administering of clinical pharmacy service —investment (ROI) of $16.70 1988–1995. Pharmacotherapy 1060 doses of influenzaper patient. 1996;16:1188-208 vaccinations and 198 pneumococcalAs hospitals increased the vaccinations to 1067 patients. 12Bond C., Raehl C. Clinicalnumber of pharmacists Pharmacy Services, Hospitalproviding pharmaceutical care, Pharmacy Staffing, and Medicationmedication errors have Errors in the United States Hospitals.decreased by over 65%. Pharmacotherapy. 2002: 22(2):134-47
Evidence of the Value of the Pharmacist Pharmacists Impact on Health Care Cost and Quality Study Citation Pharmacists reviewed drug therapy and Pharmacists providing 13Borgsdorf LR, Miano JS, Knapp KK. found ways to improve medication use pharmaceutical care to patients in Pharmacist-managed medication in nearly 65% of all patients. a managed care organization review in a managed care system. saved $640 per patient per year. American Journal of Hospital • Drug therapy changes based on the Pharmacy 1994; Mar 15; 51(6):772-7 pharmacists recommendations reduced unscheduled hospital visits, urgent care vis- Pharmacist services saved over 14Rupp MT. Value of community its, emergency room visits, and hospital days. $75,000 in 3 months time and pharmacists interventions to correct prevented additional medical prescribing errors. Annals of• Pharmacist recommended drug therapy changes problems from occurring by Pharmacotherapy. 1992 December; saved over $640 per year in health costs identifying prescribing errors. 26(12):1580-4 per individual ($280,000/year per pharmacist). Pharmacist services saved over 15Fincham J, Gottlob A. The Kansas $32 per prescription. report. Americas Pharmacist. 1997 May; 119(5): 30-3 The bulk of the savings were not Pharmacists providing 16Fincham JE, Lofhom PW. Saving related to drug costs, rather they were pharmaceutical care services to money and lives. Pharmacist care for associated with fewer unscheduled diabetic patients in their diabetes patients. Americas physician visits and fewer hospital days. community saved $219,000 Pharmacist. 1998 March; per year. 120(3): 49-52 Pharmacists providing 17Britton ML, Lurvey PL. Impact of The ASCP Fleetwood Project is a pharmaceutical care services in a medication profile review on general medicine clinic saved prescribing in a general medicine three-phase initiative to demonstrate nearly $4 per prescription and clinic. American Journal of Hospital the impact of consultant pharmacist decreased the number of Pharmacy. 1991 February; services on patient outcomes and prescriptions per patient. 48(2):265-70 health care costs. Pharmacists providing 18Bond CA, Raehl CL, Pitterle ME, The first phase of this project was pharmaceutical care in 1000 Franke T. Health care professional pharmacoeconomic analysis of the cost of hospitals saved nearly 400 lives staffing, hospital characteristics, and medication-related problems in U.S. nursing and $5.1 billion in health care hospital mortality rates. facilities and the impact of consultant costs. Pharmacotherapy 1999;19(2):130-8. pharmacist services on those costs. Bond CA, Raehl CL, Franke T. Clinical The study found that : pharmacy services, pharmacy staffing, and the total cost of care in U.S. • Consultant pharmacist-conducted drug hospitals. Pharmacotherapy 2000 June; 20(6):609-21 regimen review increases the number of patients who experience Pharmacists providing 19Leape LL, Cullen DJ, Dempsey Clapp optimal therapeutic outcomes by 43% and pharmaceutical care services in an M, et al. Pharmacist participation on saves as much at $3.6 billion annually in costs intensive care unit decreased physician rounds and adverse drug associated with medication-related problems. adverse events by 66% and events in the intensive care unit. saved $270,000 by avoiding JAMA (Journal of the American adverse events. Medical Association) 1999 Jul 21; 282(3):267-70
Evidence of the Value of the Pharmacist Pharmacists Impact on Health Care Cost and Quality Study Citation Pharmacists working with patients in their Pharmacists providing 20Galt KA. Cost avoidance, acceptance,community provided targeted patient education, pharmaceutical care in a VA and outcomes associated with a phar-systematic patient monitoring, patient feedback outpatient clinic reduced the num- macotherapy consult clinic in a Veterans and behavior modification. The economic ber of medications taken by patients Affairs medical center. Pharmacotherapy impact of these interventions was evaluated. by an average of 2.4 prescriptions. 1998 Sept-Oct;18(5):1103-11 The study found that improved patient Pharmacists providing flu and 21Grabenstein JD, et al. Community adherence to their medication regimens pneumonia immunizations pharmacists as immunization advocates: resulted in increased drug costs, increased vaccination rates in high a pharmacoepidemiologic experiment. but an overall reduction in medical costs. risk patients by 74%; saving International Journal of Pharmacy thousands of dollars in health care Practice 1993;2:5-10. Fox AT, Tjhio DA, costs associated with complications Teeters JH. Implementation of a pharma- • The average cost for asthma patients was resulting from influenza infection. cy-based immunization program within higher in the intervention group, suggesting a health care system. Pharmacotherapy improved adherence to treatment. 2000;20:365;abstract 159. Grabenstein JD, et al. Community pharmacists as • Savings for total monthly medical costs immunization advocates: cost-effective- ranged from $143.96 to ness of a cue to influenza vaccination. $293.39 per patient per month. Medical Care 1992;30:503-13 Community pharmacists providing 22Rupp MT, McCallian DJ, Sheth KK. Todays health care funding challenges pharmaceutical care to asthma Developing and marketing a community patients in an HMO decreased hos- pharmacy-based asthma management will require payers to utilize pitalizations by 77% and decreased program. Journal of the American the most cost effective care emergency room visits by 78%. Pharmaceutical Association; 1997 Nov- without compromising quality. Dec; 37(6):694-9 In one month, six pharmacists 23McMullin, T., Hennenfent J., etal. AAmericas pharmacists contain health care providing pharmaceutical care prospective, randomized trial to assess costs while improving quality... a rare decreased the drug costs from a the cost impact of pharmacist-initiated combination in todays environment. cohort of patients by 41%. interventions. Archives of Internal Medicine. 1999 Oct 25; 159(19):2306-9Other References: This study shows that costs 24Bootman JL Johnson JA. Drug-related associated with drug-related prob- morbidity and mortality. A cost-of-ill-25 Chain Industry Profile, 2001 lems exceeds $77 billion annually. ness model. Archives of Internal26 Hoovers Company Information, April 24, These costs could be cut by more Medicine. 1995 Oct 9; 155(18):1949-56 than 50% if pharmaceutical care was www.hoover.com provided to all patients.27 NACDS Economics Department Patients treated with blood thinners Chiquette E, Amato MG, Bussey HI.28 Attitudes and Beliefs About the Use of in a pharmacist-managed Comparison of an anticoagulation clinic Over-the-Counter Medicines: A Dose of Reality. with usual medical care. anticoagulation clinic had fewer Harris Interactive, Inc. 2002 Anticoagulation control, patient out- emergency room visits, fewer29 Eisenburg, D. To The Rescue. Time Magazine. comes, and health care costs. Archives hospitalizations, and showed a total 2001; April 23 of Internal Medicine 1998;158:1641-7 cost savings of $1,621 per patient.