RESUMO
Introducción: La economía de los medicamentos se puede considerar como el estudio y cálculo económico detallados del medicamento, que ayuda a satisfacer las necesidades del paciente según costo, beneficio y eficacia de dicho medicamento. Objetivo: El objetivo de la investigación fue evaluar si la valoración económica de la tableta de acetaminofén 500 mg. permitirá conocer el beneficio en el costo del fármaco en los establecimientos farmacéuticos de Lima. Métodos: La investigación presenta un diseño no experimental, transversal, descriptivo y analítico. Población: 25 trabajadores de la DIGEMID con conocimientos de farmacoeconomía; muestra: 100 por ciento de la población. Para la evaluación se utilizó un cuestionario de escala Likert, basado en las dos variables cuantitativas: Valoración económica y Coste-beneficio. El tratamiento estadístico se realizó con el programa SPSS v.25. Traducción realizada con la versión gratuita del traductor www.DeepL.com/Translator Resultados: De un total de 44 presentaciones de tabletas de acetaminofén vendidas en 41 distritos de Lima, se obtuvieron siete presentaciones que ofrecen el producto a un precio elevado, siendo estas no beneficiosas en el 15,9 por ciento y se encontraron 37 establecimientos que ofrecen el medicamento a un precio medio beneficioso (84,1 por ciento). Conclusiones: La farmacoeconomía aplicada al medicamento acetaminofén presentación tableta 500 mg permitió conocer que dicho producto tiene un costo de bajo a moderado, por lo que es asequible a la población de bajos recursos. Asimismo, la evaluación económica efectuada permitirá la toma de decisiones del consumidor al momento de la compra(AU)
Introduction: The economics of medicines can be considered as the detailed economic study and calculation of the treatment, which helps to satisfy the needs of the patient according to the cost, benefit, and efficacy of said medicine. Objective: The objective of the research was to evaluate if the economic valuation of the acetaminophen 500 mg. tablet will allow to know the benefit in the cost of the drug in pharmaceutical establishments in Lima. Methods: The research presents a non-experimental, cross-sectional, descriptive, and analytical design. Population: 25 DIGEMID workers with knowledge of pharmacoeconomics; sample: 100 percent of the population. A Likert scale questionnaire was used for the evaluation, based on the two quantitative variables: Economic valuation and Cost-benefit. Statistical processing was carried out using the SPSS v.25 program. Results: From a total of 44 presentations of acetaminophen tablets sold in 41 districts of Lima, seven presentations have been obtained that offer the product at a high price, these being not beneficial and reaching 15.9 percent, 37 establishments were found They offer the drug at a helpful average price reaching 84.1 percent. Conclusions: The pharmacoeconomics applied to the drug acetaminophen 500 mg tablet presentation allowed us to know that this product has a low to moderate cost, making it affordable to the low-income population. Likewise, the economic evaluation carried out will allow decision-making at the time of purchase, which will enable the people to identify the price(AU)
Assuntos
Humanos , Eficácia , Análise Custo-Benefício/economia , Farmacoeconomia , Acetaminofen/economia , Farmacêuticos/economia , Epidemiologia Descritiva , Estudos TransversaisRESUMO
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.
Assuntos
Unidades de Terapia Intensiva/organização & administração , Equipe de Assistência ao Paciente/organização & administração , Farmacêuticos/organização & administração , Serviço de Farmácia Hospitalar/organização & administração , Adulto , Idoso , Chile , Redução de Custos , Análise Custo-Benefício , Feminino , Custos de Cuidados de Saúde , Humanos , Unidades de Terapia Intensiva/economia , Unidades de Terapia Intensiva/normas , Masculino , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente/economia , Equipe de Assistência ao Paciente/normas , Farmacêuticos/economia , Farmacêuticos/normas , Serviço de Farmácia Hospitalar/economia , Serviço de Farmácia Hospitalar/normas , Papel Profissional , Estudos Prospectivos , Garantia da Qualidade dos Cuidados de SaúdeRESUMO
PURPOSE: The pharmacist-led implementation of a smart pump-electronic medical record (EMR) interoperability program at a hospital within a regional health system is described. SUMMARY: Smart pump-EMR interoperability involves a wireless, bidirectional connection by which infusion information transmitted by the EMR prepopulates infusion devices, reducing keystokes and opportunities for manual programming errors. The smart pumps transmit time-stamped infusion data to the EMR for nurse documentation. Use of interoperability technology forces the use of dose-error reduction software so that 100% of prepopulated infusions and dosage adjustments are protected. To improve i.v. medication safety and documentation at a 286-bed hospital within an 8-hospital health system, pharmacists led an initiative to implement smart pump-EMR interoperability as a first step toward systemwide implementation. The hospital's smart pump-EMR interoperability initiative resulted in patient safety and revenue-generation gains in the first 8 months after implementation. The mean number of keystrokes needed to program an infusion was reduced from 15 to 2 (an 86% decrease). Pump alerts, alert overrides, and reprogrammed or cancelled infusions were decreased. In addition, the program improved outpatient charge capture, resulting in $370,000 in incremental revenue. CONCLUSION: A pharmacist-led implementation of smart pump-EMR interoperability led to measurable, data-based improvements in i.v. medication safety and improved accuracy, timeliness, and efficiency of i.v. infusion documentation. Revenue was increased due to improved charge capture for outpatient i.v. infusions.
Assuntos
Registros Eletrônicos de Saúde/organização & administração , Bombas de Infusão , Farmacêuticos/organização & administração , Serviço de Farmácia Hospitalar/organização & administração , Tecnologia sem Fio , Registros Eletrônicos de Saúde/economia , Segurança de Equipamentos , Humanos , Segurança do Paciente , Farmacêuticos/economia , Serviço de Farmácia Hospitalar/economia , Fatores de TempoRESUMO
PURPOSE: Expansion of clinical pharmacist positions through sustainable funding is described. SUMMARY: The University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences was awarded a 2-year program grant to establish an integrated clinical pharmacy program for underserved residents in family health centers in northeastern Colorado. The grant enabled the hiring of 2 bilingual, full-time, board-certified, postgraduate year 2-trained clinical pharmacists to initiate comprehensive clinical pharmacy services. Clinical pharmacy services for diabetes, hypertension, and dyslipidemia management were provided during direct patient care visits using collaborative drug therapy management protocols to facilitate comprehensive medication management. Initial visits lasted 1 hour, and follow-up visits lasted 30 minutes. In addition, clinical pharmacists provided point-of-care consultations for patients seeing other healthcare providers. All patient encounters and consultations were documented in the electronic health record. Success of the clinical pharmacy program was evaluated based on the achievement of goal blood pressure values, glycosylated hemoglobin values, and low-density-lipoprotein cholesterol levels. Pharmacists' involvement in patient care activities led to improvements in all of these clinical outcomes. This coincided with unique funding opportunities with regional accountable care organizations that sought to demonstrate improved patient care in an expansion population. As a result, 2 grant-funded clinical pharmacist positions in 2 community health clinics were converted into 4 faculty positions in 5 community health centers funded by regional accountable care organizations. CONCLUSION: Collaboration with accountable care organizations resulted in the successful funding of ambulatory care clinical pharmacy services. These services resulted in improved chronic disease control and provider satisfaction.
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Conduta do Tratamento Medicamentoso/organização & administração , Farmacêuticos/economia , Farmacêuticos/provisão & distribuição , Assistência Ambulatorial/economia , Assistência Ambulatorial/organização & administração , Pressão Sanguínea , LDL-Colesterol/sangue , Colorado , Centros Comunitários de Saúde/economia , Centros Comunitários de Saúde/organização & administração , Registros Eletrônicos de Saúde , Hemoglobinas Glicadas/análise , Humanos , Área Carente de Assistência Médica , Residências em Farmácia , Sistemas Automatizados de Assistência Junto ao Leito , Apoio ao Desenvolvimento de Recursos HumanosRESUMO
BACKGROUND: Antimicrobial stewardship programs (ASP) have been implemented to promote rational use of antimicrobial drugs. Multidisciplinary teams are needed to form effective committees. OBJECTIVE: Assess the impact of ASP, with and without the presence of a pharmacist, in a cardiology hospital in Brazil. METHODS: The program started with an infectious disease (ID) physician, and after 22 months, a pharmacist started to work in the ASP team. We present data related to: stage 1-before the program implementation; stage 2-with the ID physician; and stage 3 with the inclusion of a pharmacist. Analysis was made by segmented regression of time series. RESULTS: After the start of ASP there was a significant reduction of consumption of all antimicrobials. The pharmacist contributed to the significant reduction in consumption of fluoroquinolones, clindamycin and ampicillin/sulbactam and in increase in total cephalosporins use in stage 3. Adherence rate to the ASP team recommendations was 64.1%. There was a significant reduction of 69% in hospital antibiotics costs. CONCLUSION: A non-expensive ASP in a limited resource country resulted in reductions in antimicrobial consumption and costs. The multidisciplinary team contributed to maximize the impact of interventions.
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Anti-Infecciosos/uso terapêutico , Equipe de Assistência ao Paciente/organização & administração , Farmacêuticos/organização & administração , Serviço de Farmácia Hospitalar/organização & administração , Padrões de Prática Médica , Anti-Infecciosos/economia , Brasil , Distribuição de Qui-Quadrado , Redução de Custos , Análise Custo-Benefício , Países em Desenvolvimento , Custos de Medicamentos , Uso de Medicamentos , Revisão de Uso de Medicamentos , Fidelidade a Diretrizes , Custos Hospitalares , Humanos , Comunicação Interdisciplinar , Objetivos Organizacionais , Equipe de Assistência ao Paciente/economia , Equipe de Assistência ao Paciente/normas , Farmacêuticos/economia , Farmacêuticos/normas , Serviço de Farmácia Hospitalar/economia , Serviço de Farmácia Hospitalar/normas , Guias de Prática Clínica como Assunto , Padrões de Prática Médica/normas , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Análise de Regressão , Fatores de TempoRESUMO
PURPOSE The results of a survey assessing the practice settings, clinical activities, and reimbursement experiences of pharmacists with advanced-practice designations are reported. METHODS A questionnaire was sent to all certified Pharmacist Clinicians in New Mexico and all Clinical Pharmacist Practitioners in North Carolina (a total of 189 pharmacists at the time of the survey in late 2008) to elicit information on practice settings, billing and reimbursement methods, collaborative drug therapy management (CDTM) protocols, and other issues. RESULTS Of the 189 targeted pharmacists, 64 (34%) responded to the survey. On average, the reported interval from pharmacist licensure to certification as an advanced practitioner was 11 years. The majority of survey participants were practicing in community or institutional settings, most often hospital clinics or physician offices. About two thirds of the respondents indicated that their employer handled the billing of their services using standard evaluation and management codes, with estimated total monthly billings averaging $6500. At the time of the survey, about 80% of the respondents were engaged in a CDTM protocol. The survey results suggest that pharmacists with advanced-practice designations are perceived favorably by patients and physicians and their services are in high demand, but more than one third of respondents indicated a need to justify their advanced-practice positions to administrators. CONCLUSION Pharmacists with advanced-practice designations are providing clinical services in various settings under collaborative practice arrangements that include prescribing privileges. Despite growing patient and physician acceptance, reimbursement challenges continue to be a barrier to wider use of CDTM programs.
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Atitude do Pessoal de Saúde , Certificação/economia , Comportamento Cooperativo , Planos de Pagamento por Serviço Prestado/economia , Farmacêuticos/economia , Guias de Prática Clínica como Assunto/normas , Certificação/tendências , Serviços Comunitários de Farmácia/economia , Serviços Comunitários de Farmácia/tendências , Planos de Pagamento por Serviço Prestado/tendências , Humanos , New Mexico , North Carolina , Farmacêuticos/tendências , Inquéritos e QuestionáriosRESUMO
O estudo teve por objetivo verificar o perfil dos profissionais farmacêuticos em Umuarama-PR. Foi aplicado um questionário padrão aos farmacêuticos responsáveis técnicos pelas farmácias e drogarias da cidade, elaborado com questões fechadas. Realizaram-se entrevistas com 43 farmacêuticos, mediante consentimento expresso individual e aprovado pelo comitê de ética da Universidade Paranaense (UNIPAR). Foram coletados dados pessoais do profissional, dados referentes ao tempo de atuação na área farmacêutica, formação acadêmica, remuneração e tempo de trabalho. Os dados obtidos mostraram um predomínio de profissionais (76,7 por cento) que se graduaram na UNIPAR, sendo que 14,0 por cento e 34,9 por cento, respectivamente homens e mulheres realizaram cursos de especialização em Farmacologia. O fato de os farmacêuticos buscarem atualização profissional, principalmente em farmacologia, mosta a preocupação e o interesse do profissional em estar melhor preparado para enfrentar os desafios da profissão. Os resultados demonstraram que ainda há uma pequena parcela de profissionais que se sujeitam a trabalhar por salários inferiores ao piso, porém importantes conquistas têm se concretizado por farmacêuticos que ousam, acreditam e têm transformado a realidade da sua profissão, como alguns profissionais que mesmo trabalhando por 04 horas recebem um salário acima do piso estabelecido pela categoria
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Humanos , Farmacêuticos/economia , Farmacêuticos/estatística & dados numéricos , Farmacêuticos/organização & administração , Farmacêuticos/provisão & distribuição , FarmacêuticosRESUMO
BACKGROUND: Many people with sexually transmitted diseases (STDs) in Lima, Peru, seek treatment in pharmacies. GOAL: The goal was to assess the cost-effectiveness of training pharmacy workers in syndromic management of STDs. STUDY DESIGN: Cost-effectiveness from both the program and societal perspectives was determined on the basis of study costs, societal costs (cost of medicine), and the number of cases adequately managed. The latter was calculated from estimated incidence, proportion of symptomatic patients, proportion seeking treatment in pharmacies, and proportion of cases adequately managed in both comparison and intervention districts. Univariate and multivariate sensitivity analyses were performed. RESULTS: Under base-case assumptions, from the societal perspective the intervention saved an estimated US$1.51 per case adequately managed; from the program perspective, it cost an estimated US$3.67 per case adequately managed. In the sensitivity analyses, the proportion of females with vaginal discharge or pelvic inflammatory disease who seek treatment in pharmacies had the greatest impact on the estimated cost-effectiveness, along with the medication costs under the societal perspective. CONCLUSION: Training pharmacists in syndromic management of STDs appears to be cost-effective when only program costs are used and cost-saving from the societal perspective. Our methods provide a template for assessing the cost-effectiveness of managing STD syndromes, on the basis of indirect estimates of effectiveness.