Benefit of Incorporating Clinical Pharmacists in an Adult Intensive Care Unit: A Cost-saving Study.

What is known and objective A framework to evaluate the impact of clinical pharmacists in intensive care units (ICUs) in Chile has not yet been established. This study evaluates the cost avoidance and cost-benefit ratios of clinical pharmacist interventions in terms of treatment optimization in an adult ICU in southern Chile. Methods Clinical pharmacist interventions in a multidisciplinary adult ICU were assessed between January and December 2019. Only interventions suggested by pharmacists and accepted by the healthcare team were included in the analysis. Interventions were classified into six categories, and cost avoidance (in US dollars) was calculated for each category using a systematic validated approach. A cost-benefit ratio for clinical pharmacy services in the adult ICU was also calculated. Results and discussion Over the 12-month period, 505 interventions were performed in 169 patients, of whom 62% were male. Interventions were classified into the following six categories: adverse drug event prevention (18%), which led to $87 882 in savings; resource utilization (ie change in medication route) (10%), which led to $50 525 in savings; individualization of patient care (ie dose adjustment) (36%), which led to $57 089 in savings; prophylaxis (ie initiation of stress ulcer prophylaxis) (<1%), which led to $167 in savings; hands-on care (ie bedside monitoring) (23%), which led to $57 846 in savings; and administrative and supportive tasks (ie patient own medication evaluation) (13%), which led to $9988 in savings. The total cost savings over the year-long period were $263 500, resulting in a cost-benefit ratio of 1:24.2. What is new and conclusion The participation of a clinical pharmacist in a multidisciplinary ICU team reduces healthcare expenditures through treatment optimization translated into cost avoidance. This study has corroborated prior evidence that clinical pharmacist involvement in ICUs provides economic value and quality assurance in healthcare settings.