P9. Patient outcomes: documentation of cost savings and cost avoidance

1996 ◽  
Vol 18 ◽  
pp. 49
Author(s):  
A. Mutnick ◽  
K. Sterba ◽  
H.J. Black
Keyword(s):  
Patient Outcomes ◽  
Cost Savings ◽  
Cost Avoidance

Cost Avoidance and Clinical Benefits Derived from a Pharmacy-Managed Anemia Program

2000 ◽  
Vol 35 (2) ◽  
pp. 169-175 ◽  
Author(s):  
Robert A. Quercia ◽  
Ronald Abrahams ◽  
C. Michael White ◽  
John D'Avella ◽  
Mary Campbell
Keyword(s):  
Cost Savings ◽  
Cost Effective ◽  
Hemodialysis Patients ◽  
Cost Avoidance ◽  
Number Of Patients ◽  
Epoetin Alpha ◽  
Clinical Benefits ◽  
Unit Dose ◽  
One Year ◽  
Alpha Therapy

A pharmacy-managed anemia program included distribution and clinical components, with the goal of making epoetin alpha therapy for hemodialysis patients more cost-effective. The Pharmacy Department prepared epoetin alpha doses for patients in unit-dose syringes, utilizing and documenting vial overfill. Pharmacists dosed epoetin alpha and iron (oral and intravenous) per protocol for new and established patients. Baseline data were obtained in 1994, one year prior to implementation of the program, and were re-evaluated in 1995 and 1998. Cost avoidance from utilization of epoetin alpha vial overfill in 1995 and 1998 was $83,560 and $91,148 respectively. In 1995 and 1998, cost avoidance from pharmacy management of anemia was $191,159 and $203,985 respectively. The total cost avoidance from 1995 through 1998 was estimated at $1,018,638. The number of patients with hematocrits under 31% decreased from 32% in 1994 to 21% and 14% in 1995 and 1998 respectively. We conclude that a pharmacy-managed anemia program for hemodialysis patients results in significant cost savings and better achievement of target hematocrits.

Proposed guidance on cost-avoidance studies in pharmacy practice

2021 ◽  
Author(s):  
Asad E Patanwala ◽  
Sujita W Narayan ◽  
Curtis E Haas ◽  
Ivo Abraham ◽  
Arthur Sanders ◽  
...  
Keyword(s):  
Clinical Pharmacy ◽  
Best Practice ◽  
Pharmacoeconomic Analysis ◽  
Pharmacy Practice ◽  
Cost Savings ◽  
Sensitivity Analyses ◽  
Cost Assessment ◽  
Potential Consequence ◽  
Cost Avoidance ◽  
Pharmacist Interventions

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Cost-avoidance studies of pharmacist interventions are common and often the first type of study conducted by investigators to quantify the economic impact of clinical pharmacy services. The purpose of this primer is to provide guidance for conducting cost-avoidance studies pertaining to clinical pharmacy practice. Summary Cost-avoidance studies represent a paradigm conceptually different from traditional pharmacoeconomic analysis. A cost-avoidance study reports on cost savings from a given intervention, where the savings is estimated based on a counterfactual scenario. Investigators need to determine what specifically would have happened to the patient if the intervention did not occur. This assessment can be fundamentally flawed, depending on underlying assumptions regarding the pharmacists’ action and the patient trajectory. It requires careful identification of the potential consequence of nonaction, as well as probability and cost assessment. Given the uncertainty of assumptions, sensitivity analyses should be performed. A step-by-step methodology, formula for calculations, and best practice guidance is provided. Conclusions Cost-avoidance studies focused on pharmacist interventions should be considered low-level evidence. These studies are acceptable to provide pilot data for the planning of future clinical trials. The guidance provided in this article should be followed to improve the quality and validity of such investigations.

Evaluation of the dosing strategies of biologic agents and the theoretical impact of dose rounding

2016 ◽  
Vol 24 (1) ◽  
pp. 47-55
Author(s):  
Savannah Lindsey ◽  
Laura Beth Parsons ◽  
Lindsay Rosenbeck Figg ◽  
Jill Rhodes
Keyword(s):  
Monoclonal Antibody ◽  
Monoclonal Antibodies ◽  
Medical Center ◽  
Academic Medical Center ◽  
Wholesale Price ◽  
Cost Savings ◽  
Retrospective Chart Review ◽  
Potential Cost ◽  
Cost Avoidance ◽  
The Cost

Introduction Monoclonal antibodies possess unique pharmacokinetic properties that permit flexible dosing. Increased use and high costs of these medications have led to the development of cost-containing strategies. This study aims to quantify the cost savings and clinical impact associated with dose rounding monoclonal antibodies to the nearest vial size. Methods This study was a single-arm, retrospective chart review assessing all monoclonal antibody doses dispensed at an outpatient community infusion center associated with an academic medical center between August 2014 and August 2015. All monoclonal antibody doses were reviewed to determine the cost of drug wasted using two methods. The waste-cost analysis described the amount of drug disposed of due to the use of partial vials. The theoretical dose savings described potential cost avoidance based on rounding the ordered dose to the nearest vial size. The theoretical rounded dose was compared to the actual ordered dose to explore clinical implications. Results A total of 436 doses were included. Of these, 237 were not rounded to the nearest vial size and included in the analysis. The cost of waste associated with these doses was $108,013.64 using actual wholesale price. The potential cost avoidance associated with the theoretical dose calculation was $83,595.53. Rounding these doses to the nearest vial size resulted in a median 6.7% (range, 1.4–20%) deviation from ordered dose. Conclusions Rounding monoclonal antibodies to the nearest vial size could lead to significant cost and waste savings with minimal deviation from the actual ordered dose.

The Role of the Clinical Pharmacist in a Preventive Cardiology Practice

2019 ◽  
Vol 53 (12) ◽  
pp. 1214-1219 ◽  
Author(s):  
Bruce A. Warden ◽  
Michael D. Shapiro ◽  
Sergio Fazio
Keyword(s):  
Medication Adherence ◽  
Clinical Pharmacist ◽  
Cost Savings ◽  
Pharmacist Intervention ◽  
Team Approach ◽  
Office Visits ◽  
Patient Cost ◽  
Clinical Interventions ◽  
Preventive Cardiology ◽  
Cost Avoidance

Background: Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide. In response, a multidisciplinary team approach, which includes clinical pharmacists, is recommended to improve patient outcomes. The purpose of the study was to describe interventions associated with integration of a clinical pharmacist, with an emphasis on pharmacist-generated patient cost avoidance. Methods: This is a prospective observational study detailing pharmacist-initiated interventions within an academic preventive cardiology service. Interventions targeting pharmacotherapy optimization, side effect management, patient education, medication adherence, and cost avoidance were implemented during shared office visits with providers and/or on provider consultation for remote follow-up. Tabulation of cost avoidance was arranged into 2 formats: clinical interventions implemented by the pharmacist and direct patient out-of-pocket expense reduction. Money saved per clinical intervention was extrapolated from data previously published. Patient out-of-pocket expense prior to and after pharmacist involvement was calculated to assess aggregate yearly patient cost savings. Results: Over 12 months the pharmacist intervened on 974 patients, totaling 3725 interventions. Cost avoidance strategies resulted in yearly savings of $830 748 in aggregate—$149 566 from clinical interventions and $681 182 from patient out-of-pocket expense reduction. Monthly patient out-of-pocket expense was reduced from a median (interquartile range) of $217 ($83.5-$347) before to $5 ($0-$18) after pharmacist intervention. Conclusions: Addition of a clinical pharmacist within an academic preventive cardiology clinic generated substantial pharmacotherapy interventions, resulting in significant cost avoidance for patients. The resulting cost avoidance may result in improved medication adherence and clinical outcomes.

Emerging development and use of clinical pathways to improve quality and standardize care in oncology.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 139-139
Author(s):  
Colin Nash ◽  
Ken Williams ◽  
Francesca Pirog ◽  
Kristi Mitchell
Keyword(s):  
Patient Outcomes ◽  
Clinical Pathways ◽  
Grey Literature ◽  
Cost Savings ◽  
Independent Evidence ◽  
Provider Networks ◽  
Reduced Toxicity ◽  
Oncology Practice ◽  
Evidence Based Care ◽  
The Impact

139 Background: Clinical pathways have emerged as a tool for payers to encourage provider adherence to evidence-based care. Avalere sought to understand how oncology pathway developers consider different types of evidence and physician input in designing pathways, and how the experiences of early programs may serve as an indicator for future implementation. Methods: Avalere conducted targeted white and grey literature searches to identify and analyze pathways used by oncology practice groups, provider networks, and major commercial payers. The research was augmented by informant interviews with representatives from leading organizations that have developed or implemented pathways. Results: Current pathways programs differ in their origins and objectives. Across these programs, Avalere identified findings in three key areas: Development: Developers consider efficacy of treatments first, followed by toxicity, and then cost. Many developers conduct an independent evidence review, while others leverage clinical practice guidelines. All developers solicit physician input on pathway design and updates; Use: Independent pathway developers partner with commercial insurers and large provider networks to design pathways with cost-saving components. Physicians are evaluated based on their adherence to the pathways, but are not held accountable for reporting or performance on NQF-endorsed quality measures; Impact: Cost savings in early programs are largely due to reduced toxicity-related medical costs, use of less expensive drugs, and lower total drug use. However, there is limited evidence on the impact of pathways on patient outcomes. Conclusions: There is variability across oncology pathway developers regarding their scope, granularity, and processes related to evaluating and incorporating evidence. If clinical programs demonstrate early cost reductions while improving patient outcomes, payers will likely attempt to expand pathways programs to new geographies and therapeutic areas. Existing practice patterns and previously implemented pathways programs will likely play heavily in determining which pathways are adopted in a given region, but national standardization is highly unlikely.

scholarly journals Improved Outcomes and Cost Savings Associated With Pharmacist Presence in the Emergency Department

2017 ◽  
Vol 52 (6) ◽  
pp. 433-437 ◽  
Author(s):  
Matthew W. McAllister ◽  
Joshua G. Chestnutt
Keyword(s):  
Emergency Department ◽  
Hospital Admission ◽  
Hospital Discharge ◽  
Life Support ◽  
Patient Survival ◽  
Cost Savings ◽  
Advanced Cardiac Life Support ◽  
Cost Avoidance ◽  
Improved Outcomes ◽  
Resuscitation Team

Purpose: The study sought to determine whether the inclusion of a pharmacist on the emergency department (ED) resuscitation team was associated with improved compliance with the Advanced Cardiac Life Support (ACLS) guidelines and patient survival. The study also evaluated cost avoidance associated with a pharmacist providing clinical services to the ED. Methods: Cardiac arrest event records were evaluated for compliance with ACLS guidelines as well as for whether or not a pharmacist was involved as a member of the resuscitation team. Pharmacists documented all interventions performed while physically present in the ED which were utilized to associate cost avoidance. Results: When a pharmacist assisted as a member of the resuscitation team, a significant increase in the percentage of medications administered in compliance with the ACLS guidelines was noted (78% vs 67%, P = .0255). An increase in survival to hospital admission (25% vs 17.8%, P = .0155) was also noted though no significant increase in survival to hospital discharge (15% vs 4.4%, P = .6392) was observed. Over a 5-month period, pharmacists in the ED performed 1200 interventions, which created US$98 362 in cost avoidance. This extrapolates to approximately US$320 000 per year in cost avoidance. Conclusion: Inclusion of a pharmacist as a member of the resuscitation team improved compliance with medications administered according to the ACLS guidelines and increased survival to hospital admission, though survival to hospital discharge was unaffected. The presence of a pharmacist in the ED was associated with approximately US$320 000 in cost avoidance per year, if not more.

IG@P, Our Single Online Technology Crowdsourcing Platform

2021 ◽  
Author(s):  
Fadhlan Nik Abdul Aziz ◽  
Khairul Azni Abdul Hamid ◽  
Mazlina Matlasa ◽  
Muhammad Hasif Hasan ◽  
Deenitha Ambigai Supparamaniam ◽  
...  
Keyword(s):  
Value Creation ◽  
Cost Savings ◽  
Online Technology ◽  
Cost Avoidance ◽  
Technology And Innovation ◽  
Economic Climate ◽  
Pain Points

Abstract This year has been a year of unprecedented and mounting challenges. While many had to dig deep and find ways to ride a tough economic climate, Innovation Gateway@PETRONAS (iG@P) found itself flourishing with many technology companies submitting their technology solutions to be evaluated, endorsed and included in iG@P Technology Catalog. At the end of 2019, there were 387 submissions. The number more than doubled to 824 at the end of 2020. iG@P is created to facilitate collaboration in the areas of technology and innovation for adoption and application, as well as accelerating pace in the deployment and replication of technology in PETRONAS. This paper discusses on the business pain points that iG@P has addressed and its corresponding technology value creation in cost savings, cost avoidance and cash generation.

Clinical and economic impact of pharmacist interventions in an ambulatory hematology–oncology department

2020 ◽  
Vol 26 (5) ◽  
pp. 1172-1179
Author(s):  
Jonathan de Grégori ◽  
Pauline Pistre ◽  
Meredith Boutet ◽  
Laura Porcher ◽  
Madeline Devaux ◽  
...  
Keyword(s):  
Chemotherapy Regimen ◽  
Cost Savings ◽  
Clinical Impact ◽  
Financial Impact ◽  
Drug Event ◽  
Full Time ◽  
Cost Avoidance ◽  
Clinical Pharmacists ◽  
Pharmacist Interventions ◽  
The Cost

Objectives To evaluate clinical and financial impact of pharmacist interventions in an ambulatory adult hematology–oncology department. Methods All cancer patients receiving a first injectable immuno- and/or chemotherapy regimen were included in this prospective study over a one-year period. The clinical impact of pharmacist interventions made by two clinical pharmacists was rated using the Clinical Economic and Organizational tool. Financial impact was calculated through cost savings and cost avoidance. Main results: Five hundred and fifty-eight patients were included. A total of 1970 pharmacist interventions were performed corresponding to a mean number of 3.5 pharmacist interventions/patient. The clinical impact of pharmacist interventions was classified as negative, null, minor, moderate, major and lethal in 0, 84 (4%), 1353 (68%), 385 (20%), 148 (8%) and 0 cases, respectively. The overall cost savings were €175,563. One hundred and nine (6%) of all pharmacist interventions concerned immuno- or chemotherapy regimen for cost savings of €148,032 (84% of the total amount of cost savings). The cost avoidance was €390,480. Cost avoidance results were robust to sensitivity analyses with cost of preventable adverse drug event as main driver of the model. When the cost of employing a pharmacist was subtracted from the average yearly cost savings plus cost avoidance per pharmacist, this yielded a net benefit of €223,021. The cost–benefit ratio of the clinical pharmacist was €3.7 for every €1 invested. Principal conclusions: To have two full-time clinical pharmacists in a 55-bed ambulatory adult hematology–oncology department is both clinically and financially beneficial.

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