Cost-benefit analysis of pharmacist interventions over 36 months in a university hospital

Rev Saude Publica. 2020 Sep 30:54:94. doi: 10.11606/s1518-8787.2020054001895. eCollection 2020.

Abstract

Objective: To perform a cost-benefits analysis of a clinical pharmacy (CP) service implemented in a Neurology ward of a tertiary teaching hospital.

Methods: This is a cost-benefit analysis of a single arm, prospective cohort study performed at the adult Neurology Unit over 36 months, which has evaluated the results of a CP service from a hospital and Public Health System (PHS) perspective. The interventions were classified into 14 categories and the costs identified as direct medical costs. The results were analyzed by the total and marginal cost, the benefit-cost ratio (BCR) and the net benefit (NB).

Results: The total 334 patients were followed-up and the highest occurrence in 506 interventions was drug introduction (29.0%). The marginal cost for the hospital and avoided cost for PHS was US$182±32 and US$25,536±4,923 per year; and US$0.55 and US$76.4 per patient/year. The BCR and NB were 0.0, -US$26,105 (95%CI -31,850 - -10,610), -US$27,112 (95%CI -33,160-11,720) for the hospital and; 3.0 (95%CI 1.97-4.94), US$51,048 (95%CI 27,645-75,716) and, 4.6 (95%CI 2.24-10.05), US$91,496 (95%CI 34,700-168,050; p < 0.001) for the PHS, both considering adhered and total interventions, respectively.

Conclusions: The CP service was not directly cost-benefit at the hospital perspective, but it presented savings for forecast cost related to the occurrence of preventable morbidities, measuring a good cost-benefit for the PHS.

MeSH terms

  • Adult
  • Brazil
  • Cost-Benefit Analysis
  • Hospitals, University
  • Humans
  • Pharmacy Service, Hospital / economics*
  • Prospective Studies

Grants and funding

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) funding agency has provided scholarship for the author Maurilio Souza Cazarim [grant number 2017/21240-0 from January 2018 to August 2018 and grant number 2016/03584-1 from August 2016 to August 2019], URL ( http://bvs.fapesp.br/en/pesquisador/673633/maurilio-de-souza-cazarim/ ), thus, it has contributed for the development of this paper. It highlights, the funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Opinions, assumptions and conclusions or recommendations expressed in this article are responsibility of the authors and do not necessarily reflect the viewpoint of FAPESP.