Clinical and cost avoidance benefits of integrating pharmacist intensive care unit

Abstract

Introduction: Critical care pharmacists as integral members of multidisciplinary teams, play a crucial role in enhancing clinical, economic and humanistic outcomes for all critically ill patients. In this region, however, the economic impact of critical care pharmacist have not been well investigated. Objectives: The purpose of this study was to classify and estimate critical care pharmacist interventions that are associated with cost avoidance in the intensive care units. Methods: This was a single center prospective, observational study conducted at a 30-bed adult medical and surgical intensive care unit for over 12 months. Interventions performed by the critical care pharmacist and accepted by the multidisciplinary intensive care teams were documented weekly. Interventions were retrieved monthly to be categorized and quantified for cost estimation using two systematic frameworks. Total cost avoidance was calculated by aggregating the cost avoidance values for each intervention. The average rates of cost avoidance per month were computed by dividing the total cost avoidance by the number of months the critical care pharmacist provided care. For the net benefit, we subtracted the cost of the clinical pharmacist service from the total cost savings. Results: For a cohort of 239 critically ill patients, a total of 912 interventions were recommended. Forty percent of critical care pharmacist interventions were related to the optimization of antibiotics. Cost avoidances were mainly observed in adverse event prevention (n = 170; 18%), which resulted in a cost savings of $336,189.2 and individualized patient care accounted for (n = 486; 53%) and resulted in cost savings of $304,905.46 The total cost avoidance was $697,254.1 with a benefit‒cost ratio of 5.7:1. Conclusion: The presence of pharmacists in the intensive care unit has resulted in significant cost avoidance, mainly in adverse event prevention and individualized patient care, with a substantial return on investment.