de Grégori Jonathan, Pistre Pauline, Boutet Meredith, Porcher Laura, Devaux Madeline, Pernot Corinne, L Chrétien Marie, Rossi Cédric, Manfredi Sylvain, Dalac Sophie, Gueneau Pauline, Boulin Mathieu
Department of Pharmacy, University Hospital, Dijon, France.
Department of Clinical Hematology, University Hospital and SAPHIIR-UMR 1231, University of Burgundy & Franche Comte, Dijon, France.
J Oncol Pharm Pract. 2020 Jul;26(5):1172-1179. doi: 10.1177/1078155220915763. Epub 2020 Apr 16.
To evaluate clinical and financial impact of pharmacist interventions in an ambulatory adult hematology-oncology department.
All cancer patients receiving a first injectable immuno- and/or chemotherapy regimen were included in this prospective study over a one-year period. The clinical impact of pharmacist interventions made by two clinical pharmacists was rated using the Clinical Economic and Organizational tool. Financial impact was calculated through cost savings and cost avoidance. Five hundred and fifty-eight patients were included. A total of 1970 pharmacist interventions were performed corresponding to a mean number of 3.5 pharmacist interventions/patient. The clinical impact of pharmacist interventions was classified as negative, null, minor, moderate, major and lethal in 0, 84 (4%), 1353 (68%), 385 (20%), 148 (8%) and 0 cases, respectively. The overall cost savings were €175,563. One hundred and nine (6%) of all pharmacist interventions concerned immuno- or chemotherapy regimen for cost savings of €148,032 (84% of the total amount of cost savings). The cost avoidance was €390,480. Cost avoidance results were robust to sensitivity analyses with cost of preventable adverse drug event as main driver of the model. When the cost of employing a pharmacist was subtracted from the average yearly cost savings plus cost avoidance per pharmacist, this yielded a net benefit of €223,021. The cost-benefit ratio of the clinical pharmacist was €3.7 for every €1 invested. To have two full-time clinical pharmacists in a 55-bed ambulatory adult hematology-oncology department is both clinically and financially beneficial.
评估药剂师干预对门诊成人血液肿瘤科室的临床和财务影响。
本前瞻性研究纳入了所有接受首个免疫和/或化疗方案注射治疗的癌症患者，为期一年。两名临床药剂师进行的药剂师干预的临床影响使用临床经济和组织工具进行评估。通过成本节约和成本避免来计算财务影响。共纳入558例患者。总共进行了1970次药剂师干预，平均每位患者3.5次药剂师干预。药剂师干预的临床影响分别归类为负面、无影响、轻微、中度、重大和致命，各有0例、84例（4%）、1353例（68%）、385例（20%）、148例（8%）和0例。总体成本节约为175,563欧元。所有药剂师干预中有109次（6%）涉及免疫或化疗方案，成本节约148,032欧元（占成本节约总额的84%）。成本避免为390,480欧元。以可预防的药物不良事件成本作为模型的主要驱动因素进行敏感性分析时，成本避免结果稳健。从每位药剂师的平均年度成本节约加上成本避免中减去雇佣药剂师的成本后，净收益为223,021欧元。临床药剂师的成本效益比为每投入1欧元收益3.7欧元。在一个拥有55张床位的门诊成人血液肿瘤科室配备两名全职临床药剂师在临床和财务方面均有益处。
