Economic Impact of clinical pharmacist interventions in the Neonatal Intensive Care Unit in Qatar

Objectives

The economic benefit of the clinical pharmacist’s role in ensuring the optimum use of medicines is potentially considerable, particularly when it comes to critical care management. This study sought to evaluate the overall economic impact of clinical pharmacist interventions in the main Neonatal Intensive Care Unit (NICU) in Qatar.

Design

Retrospective analysis of the total economic benefit.

Method

From the public healthcare hospital perspective, this was a retrospective analysis of the total economic benefit of the clinical pharmacy interventions. Patient records in March 2018, July/August 2018, and January 2019 were retrospectively reviewed at the NICU of Women’s Wellness and Research Center in Hamad Medical Corporation. The total benefit from interventions was the total of cost avoidance due to preventable adverse drug events (ADEs) plus any cost savings associated with therapeutic-based resource use. Cost savings was defined as the reduced cost of therapy because of the intervention by subtracting the cost of after-clinical pharmacy intervention therapy from the cost of before-clinical pharmacist intervention therapy. Cost avoidance was defined as eliminating a potential increase in the costs related to ADEs, by multiplying the estimated probability of an ADE in the absence of intervention by the cost of an ADE.

Results

During the study period, a total of 513 interventions for 150 neonates in the NICU were analyzed. The total population benefit was QAR 1,062,417 (US$ 291,793), constituting cost avoidance of QAR 1,050,679 (US$ 288,569) and cost savings of QAR 11,738 (US$ 3,216). Our analysis showed that the most common MRPs intercepted by the clinical pharmacists were related to dosing (63%), followed by appropriateness of therapy (29%). The uncertainty analysis demonstrated the robustness of outcomes.

Conclusions

The clinical pharmacist intervention increased the resource use and its cost. In overall, however, taking avoided cost of ADEs in consideration, it is an economically beneficial practice in the NICU, associated with ADEs prevention and substantial economic benefits.