Clinical pharmacists make economic sense

Clinical pharmacy services can significantly help curb prescription drug spending and other healthcare costs, according to a new study. According to the University of Illinois at Chicago, for every dollar spent by hospitals and health systems to provide clinical pharmacy services, $4.81 was saved by the resulting lower drug costs, reductions in adverse drug events and medication errors, and other savings.

The researchers examined 93 studies on clinical pharmacy services from 2001 through 2005. “This is pretty consistent with the savings we have seen in previous years. Over time, regardless of the kind of clinical pharmacy services or the patients served … you see this savings,” said Glen Schumock, a senior author of the study and director of UIC’s Center for Pharmacoeconomic Research. Other authors of the study, recently published in the journal Pharmacotherapy, included Alexandra Perez with Nova Southeastern University, Fred Doloresco with the University of Wisconsin, and Pat Meek with the Albany College of Pharmacy,  Dan Touchette, University of Illinois at Chicago, Lee Vermeulen, University of Wisconsin-Madison, and James Hoffman, St Jude Children’s Research Hospital and the University of Tennessee.

Most of the studies took place in hospital pharmacies. However, many were also conducted in ambulatory care clinics, physicians’ offices, and in community pharmacies. “A higher proportion of these studies are coming from settings other than hospitals in recent years. It shows that other facilities are offering these services,” Schumock said.

While clinical pharmacy services have been available since the late 1970s, they have become more common in recent years.

The services in the study included general pharmacotherapeutic monitoring services, target drug programs, and disease state management services. In nearly 70 percent of the studies (about half of the 93 were studied by the researchers because of their economic focus), a positive economic benefit was associated with clinical pharmacy services.

Most of the savings resulted from direct medical costs, such as lower drug costs and lessening patients’ hospital stays or doctor visits. Schumock urged pharmacists to communicate the savings of clinical pharmacy services with healthcare administrators to support new or existing clinical pharmacy services. “During the past two decades, the role of the clinical pharmacist in many settings has expanded dramatically; yet, justifying the investment in new pharmacy resources has also become increasingly challenging,” Schumock said.

Particularly in this tough economic climate, some pharmacy directors are being asked to justify their existing clinical pharmacy services. “The first thing administrators look at is ‘Why do we have all these clinical pharmacists?’ They don’t understand the benefits of their services,” Schumock said. Therefore, pharmacists can extrapolate information from specific studies within this research, to help present a business case at their facilities.

For example, for pharmacists and pharmacy directors who want to establish clinical pharmacy services for managing diabetes in a community pharmacy, Schumock suggested examining the research on other facilities that saved money by using clinical pharmacy services in diabetes management programs.

“In the study facility, if they see 100 diabetic patients a month, and you think you’re going to have 50 patients, adjust the results accordingly,” Schumock said. Based on the other studies, present the resulting estimated savings to administrators in the form of a business plan, he suggested.

“Especially if you are developing a new service, it is not just the economic savings that should be included. Include the stakeholders, the number of patients that would be interested in the services, other facts. Make it like a regular business plan that you can present to your decision-maker, instead of just handing them a study,” Schumock said.