Cost-effective implementation of clinical pharmacy services in an ambulatory care clinic

Implementation of clinical pharmacy services in the current economic environment of the health care system requires cost justification of the service in addition to quality patient care services. Herein described is the evaluation of the cost effectiveness of a clinical pharmacy service implemented in an ambulatory care clinic of a regional Veterans Administration Medical Center. This evaluation assessed the ability of a clinical pharmacist to decrease the prescribing of nonsteroidal anti-inflammatory drugs (NSAIDs) by clinic physicians. Through analysis of prescription data prospectively collected for a period of 18 months, average cost of NSAIDs both before and after initiation of a clinical pharmacy presence was evaluated. A comparison was made between Evaluation Clinic providers (EC) and all other ambulatory care providers (OAC). The decrease in the average cost/prescription of NSAIDs for EC and OAC was 23.4% and 5.2% (P less than 0.005), respectively. This decrease was associated with a net annual savings in drug costs of $38,776. This single intervention cost-justified a clinical pharmacist's position.