PHP14: COST ANALYSIS OF PHARMACEUTICAL SERVICES IN A TEACHING INSTITUTION

Abstract

OBJECTIVES: The study purpose was to describe and quantify annual costs of pharmaceutical services per category (5) and clienteles (5) in a 452 bed mother and child teaching institution. METHODS: Based on a daily diary completed by each pharmacist, we calculated costs of pharmaceutical services in five categories in 1999–2000: distribution, management, clinical, teaching and research. Pharmacists were requested to provide a description of their activities, including the number of new patients/follow-up, verbal and written requests and number/type of interventions. Costs ratios were calculated. RESULTS: 1999–2000 fiscal year showed 21,330 admissions, 115,961 patient-days and 275,000 outpatient visits. Pharmacists represented 47% of total worked hours. Pharmacists' total hours reported represented 89,6 % of accounting data. Hours were dedicated to distribution (53%), clinical (29%), management (12%), teaching (5%) and research (1%) services. Pharmacists answered 26 491 questions while providing 26 065 interventions among 5 clienteles (intensive care, pediatrics, multi-specialties, mother and child and haematology/oncology). We calculated a ratio of interventions/worked hours with an average of 0,61 (min 0,015–max 1,35). An analysis of these differences will be provided. Pharmacists' total annual costs represented $1,453,000.00 CDN including social benefits. Assuming our pharmacy model optimizes the number of potential interventions in our setting and that 100 % of pharmacist's paid time is required to materialize them, we calculated an average cost of $54.92 CDN/intervention (min $24.80 CDN–max $2,233.00 CDN). Differences were calculated between 1998–1999 and 1999–2000 showing an average of 104% difference (min 68%–max 197%). Differences can be explained by pharmacist expertise evolution, management decisions and changes in activity volumes. CONCLUSION: There are little data available to allow benchmarking in the costs of pharmaceutical services. Further studies are required to identify the most useful ratios to monitor such costs as well as relevant outcomes.