Article Text
Abstract
Background and Importance Multiple studies have shown a high rate of drug-related problems (DRP) in patients with cancer. To reduce this risk, several oncology departments have set up multidisciplinary assessment programmes that include pharmaceutical consultation.
Aim and Objectives In a context of limited resources allocation, our study aims to evaluate the economic impact of clinical pharmacists’ interventions (PIs) on DRP detection from a hospital perspective.
Material and Methods A French prospective non-interventional double-centre study was set up in 2020. Patients treated for solid tumours were included between February 2020 and March 2021.
First, we calculated the pharmaceutical time based on consultations and analysis times. The time spent has been valued (i) to an average annual full-time equivalent (FTE) and (ii) by the grade of the contributor (2022 salary scales). Two scenarios have been established (low/high salary grades).
Second, we selected PIs regarding clinically significant drug-drug interactions related to drug toxicity (evaluation made by an expert panel). We sought to estimate the cost based on the avoided clinical consequences. We valued the likely ‘diagnosis related groups’ of the avoided event thanks to the 2019 national survey on hospital costs. Costs were weighted by an occurrence probability based on the level of evidence: p=0.01 for very low; p=0.1 for low; p=0.4 for moderate; and p=0.6 for high.
Results 438 cancer patients were included: 62% of males, mean age of 65+/-13 years.
Per patient, the pharmacist average time was 39+/-15 minutes: 23+/-7 minutes of interview and 16+/-11 minutes of analysis. Total time was 283 hours, and the estimated annual FTE was 0.13. The total cost was estimated between €4,199 (low salaries) and €5,250 (high salaries) per year. Cost was estimated between €11.4 and €14.3 per patient and between €18.42 and €23.02 per drug-drug interaction.
122/266 PIs were evaluated to be clinically significant drug-drug interactions related to drug toxicity that could have caused a hospitalisation. Cost of hospitalisation for these serious avoidable adverse events was estimated on average at €4,869. Avoided hospitalisation costs were estimated at €180,633.
Conclusion and Relevance Clinical pharmacists are an indispensable and legitimate member of therapeutic assessment programmes for cancer patients. They help in reducing DRP in a cost-effective manner.
Conflict of Interest No conflict of interest.