Potential cost savings by prevention of adverse drug events with a novel medication review program

Abstract

Objectives: Preventable adverse drug events (ADEs) account for appreciable health care costs and patient morbidity and offer an attractive opportunity for health care providers to improve patient care and decrease costs. It has been suggested that pharmacist intervention can prevent admissions and readmissions due to ADEs. This study assessed the ADEs prevented through a novel medication review program, then estimated the potential cost savings of the prevented ADEs using the literature on cost and prevalence of ADEs that were treated.

Methods: An innovative pharmacist-run medication review was implemented in 2 pharmacies from November 2016 to July 2017. Patients with diabetes, chronic obstructive pulmonary disease, congestive heart failure, prior myocardial infarction, or stroke were included. Pharmacists recorded information about each potential ADE prevented using a standard tracking form which was de-identified and retrospective cost analysis was conducted. Estimates of ADE cost and prevalence requiring treatment were extracted from the literature and incorporated into a model to estimate the potential savings in prevented ADEs overall and per patient. Because ADE costs vary with severity, ADEs in this study were scored for potential severity.

Results: This study included 436 patients with a total of 272 likely and 385 likely or possible ADEs identified. ADEs prevented resulted in an estimated total potential savings of $94,832 (sensitivity analysis [SA]: $2261-$828,921) for likely ADEs and $138,914 (SA: $13,520-$264,308) for likely and possible ADEs. Per patient estimated medication review savings were $218 (SA: $5-$1901) for likely ADEs and $319 (SA: $31-$606) for likely and possible ADEs. The benefit of potential cost savings from providing this medication review was 3.6-5.3 times the pharmacists' time and salary cost.

Conclusions: Pharmacists in this study identified a numerous potential ADEs. By intervening to prevent these ADEs, pharmacists could generate substantial cost savings.