Impact of a central review oncology clinical pharmacist in a community oncology practice.

Abstract

68 Background: The impact and role of a clinical pharmacist in a community oncology setting is not well-described in the literature. The US Oncology Network recently implemented a central clinical pharmacist review program (ClinReview) to offer oncology remote clinical pharmacist services to practices. Methods: An oncology-trained clinical pharmacist electronically reviewed recently placed or modified chemotherapy regimen orders within a community oncology practice. The ClinReview pharmacist identified opportunities to modify ordered therapy based on clinical components, waste reduction, or financial stewardship. Recommendations were discussed with the treating oncologist at the practice or modified if permitted by approved practice policy. The pharmacist was appointed at 0.5 full-time equivalents (FTE). Financial and workload metrics were tracked to monitor the impact of the pharmacist work. Results: In 10 weeks, 388 reviews were documented and 191 (49.2%) required a modification by the pharmacist. Recommended modifications included dose rounding (n=90, 47%), a clinical change (n=72, 38%), or product substitution (n=29, 15%). The most common clinical changes included modifications to supportive care (n=32, 44%), recommendations for additional monitoring (n=19, 26%), or modifications to anti-cancer medication dose or frequency (n=18, 25%). The financial impact of the pharmacist resulted in margin improvements totaling $106,043 and a $462,305 reduction in the total cost of care in medication expenses (Table). The expense of the pharmacist during this period was $18,095. The return on investment for the pharmacist compared to margin improvement was 590%. Conclusions: An oncology clinical pharmacist is a cost-effective and valuable member of the care team in community oncology practice. The pharmacist identified opportunities to improve medication safety, regimen optimization, and demonstrated significant financial impact for the practice, payers, and patients.[Table: see text]