The value of Pharmacists

1. 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. America's
• 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 of
pharmacists 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

2. Evidence of the Value of the Pharmacist
Pharmacists Impact on
Health Care Cost and
Quality Study Citation
Pharmacists providing 6Hatoum HT, Witte KW, Hutchinson
During a 6-month period, pharmacists
pharmaceutical care to RA. Patient care contributions of
clinical pharmacists in four
joined doctors, residents, and other
patients in an ambulatory
care 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 teaching
Pharmacist services provided in 7Dobie RL, Rascati KL. Documenting
hospital.
community pharmacies saved the value of pharmacist
approximately $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 events
patients 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 adverse
practice 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 interventions
the 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 and
Pharmacists collaborating with frequency, less-than-optimal drug choices,
Vanderwoud K. The impact of the
physicians 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):469-72
per patient in drug costs.
10Munroe WP, Kunz K, Dalmady- Pharmacists working in their
Pharmacists 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 by
community saved an average
management in a community
of $2700 per year per patient advising high-risk patients of
pharmacy setting. Clinical
in 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 evaluations
generate a return-on- with pharmacists administering
of clinical pharmacy service —
investment (ROI) of $16.70
1988–1995. Pharmacotherapy 1060 doses of influenza
per patient. 1996;16:1188-208 vaccinations and 198 pneumococcal
As hospitals increased the vaccinations to 1067 patients.
12Bond C., Raehl C. Clinical
number of pharmacists
Pharmacy Services, Hospital
providing pharmaceutical care,
Pharmacy Staffing, and Medication
medication errors have
Errors in the United States Hospitals.
decreased by over 65%. Pharmacotherapy. 2002:
22(2):134-47

3. 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. America's 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. America's
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

4. 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.
Today's 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. A
America's 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 today's environment. cohort of patients by 41%. interventions. Archives of Internal
Medicine. 1999 Oct 25; 159(19):2306-9
Other 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 Internal
26 Hoover's 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, fewer
29 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.

5. Evidence ot the Value of the Pharmacist