薬剤師による薬学的介入から得られる医療経済効果の推算

Abstract

Pharmacists have increased the provision of pharmaceutical care services to patients. However, the financial benefit of various pharmaceutical interventions has not been well described. In this study, we estimated the original economic impact associated with pharmaceutical interventions by an evidenced-based approach.We classified pharmaceutical interventions into 12 items, which included preventions of serious adverse drug reactions (ADRs), and avoidance of drug interaction. The cost saving associated with preventions of serious ADRs was calculated as ￥2,140,000 per case based on the amount of costs that were paid by the Pharmaceuticals and Medical Devices Agency. Interventions to transvenous antimicrobial therapy were estimated to have a cost saving of ￥190,000 per case based on the literature in Japan. The rates of preventing serious ADRs related to chemotherapy orders, high-risk drugs and others were 5.21%, 3.91% and 2.6%, respectively, based on the literature in the United States. Using this rate, the values of intervention related to chemotherapy orders, high-risk drugs and others were ￥112,000, ￥84,000 and ￥56,000, respectively.The number of interventions was 209 per year, including 3 avoidances of serious ADRs. According to the number of interventions, we calculated that the total cost saving associated with pharmaceutical interventions was ￥22,816,000.This is the first study to estimate the economic impact associated with various pharmaceutical interventions of pharmacists in Japan. Evaluating the economic impact in relation to the pharmaceutical interventions is an important method for assessing the role of pharmacists.