Background: Healthcare costs have become a recurrent topic and discontinuity of care is a critical point since it could imply a degradation of patients’ health and an increase in health resources’ use. The pharmacist’s impact in out-/inpatient setting and continuity of care has already been proven in terms of clinical gains. However, their economic benefit has yet to be demonstrated in Switzerland.
Methods: 118 hospitalized patients in a Swiss regional hospital were included. 14 local community pharmacies (CP) participated in. The objective was to determine the costs saved by means of pharmaceutical interventions (PI) either in hospital (Hosp) or in CP. The cost saved was based on the direct prices of patient’s daily treatment and was determined at Hosp and at CP discharge in two distinct groups: one undergoing a set of pharmaceutical hospital discharge interventions (intervention group: medication reconciliation at admission; medication review during hospital stay; medication reconciliation at discharge and patient education on discharge prescriptions) and the other receiving usual care at discharge (control group). Both groups underwent a CP intervention.
The costs of healthcare professionals involved were subtracted from the previously determined saved costs. This cost-benefit analysis (CBA) allowed attesting the financial impact of PI.
Results: When comparing intervention with control group at hospital discharge, in-hospital PI saved CHF 70 per month per patient (/m/p). In addition, this study demonstrates that the dual intervention (Hosp and CP discharge PI, both combined) resulted in a saving of CHF 40/m/p. The standard care in control group currently already saved about CHF 29/m/p after the CP discharge PI.
CBA demonstrated a mean benefit of CHF 7/m/p at hospital discharge in the intervention group. This mean benefit decreased to a lost of CHF 27 if the dual intervention is considered. This decrease could be explained by the CP prescription validation: dispensing higher packaging, distribution of omitted treatment and time related to this activity. By relating this with the number of hospital discharges per month, i.e. 417 in the study hospital, a net profit of CHF 2’900 per month at hospital discharge was highlighted.
Conclusion: This study demonstrates an economic benefit obtained by optimizing hospital discharge. PI at hospital leads to a diminution of interventions at CP and the dual intervention leads to cost savings on treatments per day and per patient.