Chapter 2 - Economic Evaluation of Community and Hospital Pharmacy Services: An Introductory Review

Abstract

This chapter provides an introductory review synthesizing the literature from 2010 to 2015 concerning various methods of health economic evaluations used in hospital- and community-based studies of pharmacy services. A review of the literature (2010–15) was performed to identify relevant, peer-reviewed articles. We provided a synthesis of the methodologies utilized in performing economic evaluations of hospital and community pharmacy services as well as their clinical benefit and cost-effectiveness. Fourteen articles were included in this review. Four main methodologies of economic evaluation were recorded. These methodologies were cost-minimization analysis, cost–benefit analysis, cost-effectiveness analysis, and cost–utility analysis. Cost–utility analysis was the most utilized measure when compared with cost–benefit analyses and cost-effectiveness analysis. Cost-minimization analysis was not utilized by studies in this review. The limited use of cost–benefit analyses when compared with cost–utility analysis is likely due to the technical challenges in quantifying the cost of clinical benefits, risks, and outcomes. Hospital pharmacy services and interventions provided several clinical benefits including improvements in patient health outcomes and a reduction in adverse medication use and all studies were considered cost-effective. Community pharmacy services were acknowledged to be cost-effective in 8 out of 10 studies. The chapter concludes that the economic evaluations of hospital and pharmacy services are becoming increasingly commonplace to enable an understanding of which health care services provide value for money. This is also useful to inform policy makers as to which services will be cost-effective in light of limited health care resources.