The economic impact of clinical pharmacists in a tertiary care centre in Germany: pharmacoeconomic benefit calculation using cost-avoidance analysis

Pharmacoeconomic evaluation of clinical pharmacy services (CPS) aims to assess the contribution of clinical pharmacists (CP) to optimize the medication process by interventions while simultaneously saving costs. The objective of this study was to provide a valuable contribution by calculating the pharmacoeconomic benefit per full-time equivalent (FTE) comparing costs of avoided adverse drug events (ADE) with CP wage costs in a German tertiary care centre. CPs recorded their interventions according to an internal documentation tool, and an expert panel evaluated the likelihood that these interventions would have averted an ADE. The internal cost-avoidance analysis involved determining the total amount of ADE excess costs that could potentially be avoided in 2021. This was achieved by multiplying the median probability of an ADE occurring, as evaluated by an expert panel, by the inflation-adjusted ADE excess costs. These factors, in combination with CP wage costs contributed to the calculation of the pharmacoeconomic benefit. FTEs were used to improve comparability. Deterministic sensitivity analysis was conducted for relevant parameters. Some 221 out of 3,562 recorded active interventions were analysed. The major interventions made by CPs were medication stops or dosage changes, representing more than 50% of all CPS provided in 2021. To sum up, the findings demonstrated that interventions preventing ADEs are beneficial. A pharmacoeconomic benefit of €13,467 per FTE was calculated. The sensitivity analysis revealed further savings potential, as our model was based on rather conservative assumptions. This study has demonstrated pharmacoeconomic benefits of CP interventions. The necessity of integrating CPs into routine care to improve patient care quality while increasing economic efficiency has been proven. Future studies should investigate the long-term effects of these interventions and their implementation in other healthcare facilities to determine the full potential of CPs.