Seven years of experience with a pharmacokinetic service.

There have been several reports describing the impact of pharmacokinetic services on cost containment. The purposes of this report are to describe seven years of experience with the operation of a pharmacokinetic service, and the processes used to implement and maintain the service along with a discussion of the impact of the service on hospital cost and patient charge containment. The major functions of the pharmacokinetic service are to; 1) provide clinical pharmacokinetic and pharmacology consultation upon physician request, 2) coordinate the scheduling of serum drug levels (SDLs), and 3) provide quality assurance and utilization review reports related to the service. Data gathered from the service are reported to the medical staff monthly and are incorporated into the hospital's on-going drug usage evaluation. The results of continuous review demonstrate that direct intervention of a pharmacokineticist and a systematic approach to drug level scheduling yielded less than 1% of inappropriately collected SDLs, and in the latest year, a yearly patient charge savings of +116,304. In another study evaluating the service, it was demonstrated that when aminoglycoside dosages are adjusted by a pharmacokineticist, a patient charge savings of +491 per patient is realized. This review of seven years of experience with a pharmacokinetic service supports the conclusion that these services can have a beneficial impact on hospital costs. Furthermore, data gathered from the service can be utilized for the hospital's overall quality assurance program.