The Outcome of Clinical Pharmacists' Interventions in a Taiwanese Hospital on Pharmacoeconomics and Cost Saving

Objective In this study, we indented to evaluate the cost implications after preventing drug adverse events of inpatients by the proper interventions made by clinical pharmacists in a Taiwanese hospital. Methods Five clinical pharmacists who were assigned to intensive care units, neurology, cardiology, and nephrology wards documented all interventions with a standardized form. The data were retrospectively evaluated for the following information: (1) categories of drug-related problems; (2) general descriptions of the interventions; and (3) the clinical outcomes of the pharmacist-provided interventions. These pharmacist-provided interventions were independently reviewed by one clinical pharmacist and one physician to determine the probability that an adverse drug event (ADE) would have occurred without the intervention, the severity of potential ADEs, and the clinical significance of the interventions. The potential cost avoidance of the interventions was estimated calculating the payments for the potential ADEs. Results A total of 460 interventions provided by pharmacists were documented from December 2010 to May 2011. The most commonly documented interventions made by pharmacists were the recommendations of dosage adjustment s (48.7%). Approximately, 89.3% of pharmacist recommendations ( n  = 411) were accepted by physicians in the therapeutic team. The potential cost saving of the documented interventions during a 6-month period was calculated to be between 3,692,019 and 9,110,880 in National Taiwan Dollars (NTD), and the potential benefit:cost ratio was estimated as high as 8.4:1. Conclusion Interventions provided by hospital clinical pharmacists significantly prevented potential ADEs by monitor actively drug therapy and patient safety at the intensive care unit, cardiology, neurology, and nephrology care units. To the best of our knowledge, this is the first study to document the potential cost saving and obtained a benefit:cost ratio of 8.4:1 based on the implementation of a proper medication management and use provided by five clinical pharmacists for 6 months in a Taiwan hospital.