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PHARMACOECONOMICS

Economic Impact of Pharmacists' Interventions with Nonsteroidal Antiinflammatory Drugs

at time of writing, Pharmacy Resident, Département d'Information Médicale, Unité de Méthodologie en Evaluation Médicale, Hospices Civils de Lyon, Lyon, France; now, Hôpital Pneumologique et Cardio-Vasculaire Louis Pradel, Bron, France

Sandrine Couray-Targe, MD

Hospital Practitioner, Département d'Information Médicale, Unité de Statistique Appliquée, Hospices Civils de Lyon

Cyrille Colin, MD PhD

Professor of Public Health, Coordinator, Département d'Information Médicale, Hospices Civils de Lyon

Geneviève Chamba, PhD

Professor of Pharmacology, Département de Pharmacologie, Faculté de Pharmacie – ISPB, Lyon, France

Reprints: Adrienne P Guignard MPH, Service Pharmaceutique, Hôpital Pneumologique et Cardio-Vasculaire Louis Pradel, 28, avenue Doyen Lépine, 69500 Bron, France, FAX 00 33 4 72 35 73 31, E-mail adrienne.guignard{at}chu-lyon.fr

OBJECTIVE: To estimate the economic impact of community pharmacists' interventions following the detection of problems related to nonsteroidal antiinflammatory drugs (NSAIDs), whether in a prescription or self-medication format. The evaluation focused on the gastroduodenal adverse events that could be avoided and the subsequent savings of healthcare resources spent on treating these adverse effects.

METHODS: A previous study conducted during a 12-week period in 924 French community pharmacies provided the number of interventions for drug-related problems concerning NSAIDs. A simulation model was constructed to compare 2 strategies: a systematic pharmacist's intervention and the absence of intervention. The base-case patient was assumed to have been taking an NSAID for 3 months. The model's inputs were extracted from medical literature and from an institutional medical database.

RESULTS: In this study, 608 interventions were the results of NSAID-related problems. All of these interventions reduced the risk of gastrointestinal adverse events and avoided a total cost of 37 300.

CONCLUSIONS: This model indicates that the dispensing of NSAIDs by pharmacists and related pharmaceutical care activities have a positive impact by reducing the number of gastrointestinal complications. The model quantifies the costs thus avoided. It also underlines the necessity of effective collaboration between the prescriber and the pharmacist if optimal patient management is to be achieved.

Key Words: adverse events, community pharmacy, nonsteroidal antiinflammatory drugs

Published Online, January 17, 2003. www.theannals.com, DOI 10.1345/aph.1C134

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