Reimbursement for clinical pharmaceutical services

Area of Science:

• Health Economics
• Pharmaceutical Services
• Clinical Pharmacy

Background:

• Reimbursement for clinical pharmaceutical services is often bundled with drug costs.
• There is a need to delineate and charge for distinct clinical pharmacy interventions.
• This study examines the financial viability and physician/patient acceptance of separate billing for specific services.

Purpose of the Study:

• To describe and evaluate the reimbursement process for four distinct clinical pharmaceutical services.
• To assess physician and patient reception to these services.
• To determine the financial impact of offering these services separately.

Main Methods:

• Documented the provision of four clinical pharmaceutical services: growth hormone home instruction, patient consultation, patient visit, and pharmacokinetic consultation.
• Tracked service requests, charges, and documentation from May to August 1977.
• Collected qualitative feedback from physicians and patients.

Main Results:

• A total of 71 services were requested by 27 physicians over a four-month period.
• Total charges generated amounted to $4,492.
• Average monthly charges stabilized at approximately $1,100.

Conclusions:

• Clinical pharmaceutical services can be successfully reimbursed separately from drug fees.
• Physician and patient feedback was positive, suggesting value and acceptance.
• Separate reimbursement models for clinical pharmacy services are financially sustainable.