Effectiveness of Outpatient Pharmaceutical Clinics in the Overseeing of Self-Injectable Biologic Prescriptions for Inflammatory Immune Diseases and the Cost-Effectiveness of Pharmacological Management

Pharmacists provide pharmacological management prior to a physician visit, which is effective for the smooth introduction of biologics and the avoidance of serious side effects. However, pharmacists face challenges in implementing pharmacological management through dispensing alone. Furthermore, reports on the high risk of side effects associated with biologics remain limited. In this study, we investigated the cost-effectiveness and clinical impact of pharmaceutical management in outpatient pharmaceutical clinics for inflammatory immune diseases, from before the introduction of biologics until 52 weeks after introduction. The number of pharmacological management cases and their associated cost-effectiveness were compared between dispensing and outpatient pharmaceutical clinic groups. Patients aged ≥18 years with an autoimmune disease who were instructed to self-inject biologics between April 2018 and March 2023 were included. The primary outcome was the number of pharmacological management cases performed at the time of biologic introduction. A total of 264 eligible patients were identified, of whom 54 were excluded. After propensity score matching, patients were assigned to 2 groups (n = 67 each). Pharmacological management was significantly more common in the outpatient pharmaceutical clinic group (p < 0.05) than in the dispensing group. In the outpatient clinic group, 10 patients (14.9%) avoided severe adverse events, whereas avoidance was not observed in the dispensing group. The financial benefits of pharmacological management were 915000 and 26091000 yen in the dispensing and outpatient pharmaceutical clinic groups, respectively. Overall, this study demonstrated that pharmacist-led outpatient clinics targeting inflammatory autoimmune diseases can help prevent serious adverse drug reactions and are significantly cost-effective.