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Pharmaceutical Economics

Pharmaceutical Economics. Heng-Sim Lee RPh MS Director of Pharmacy, ChiaYi Branch, Taichung Veterans General Hospital Clinical Nutritional Pharmacist Council Member of Taiwan Society of Parenteral and Enteral Nutrition (TSPEN)

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Pharmaceutical Economics

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  1. Pharmaceutical Economics Heng-Sim Lee RPh MS Director of Pharmacy, ChiaYi Branch, Taichung Veterans General Hospital Clinical Nutritional Pharmacist Council Member of Taiwan Society of Parenteral and Enteral Nutrition (TSPEN) Professional Representative of Parenteral and Enteral Nutrition Society of Asia (PENSA) Council Member of Chia Yi city Pharmacist Association Lecturer of Nursing Institute, Hung Kuang University 1952 1990 2003 30th Nov. 2013

  2. Pharmaceutical Care 30th Nov. 2013

  3. Hospital Pharmacists move closer to Patient Care Changes in Pharmacy Practice What is Pharmaceutical Care? The Pharmacist becomes more specialised as a therapeutic advisor 30th Nov. 2013

  4. Pharmaceutical Care Quality Assurance of Drug Therapy NeedGoalProcessOutcome 30th Nov. 2013

  5. Pharmaceutical care • ‘’Pharmaceutical care is the direct, responsible • provision of medication-related care for the • purpose of achieving definite outcomes that • improve a patient’s quality of life.’’ • Cure of the disease • Elimination or reduction • of symptoms • Arrest or slowing of a • disease process • Prevention of disease • or symptoms • Hepler CD and Strand LM (1990) 30th Nov. 2013

  6. Clinical Pharmacist serves 60 beds Clinical Pharmacist integrates into medical specialties Pharmacist as ward visitor serves 120 beds Emergence of the Teacher-Practitioner Variety of models Pharmacy Patient Computer Records and Services to Elderly Nursing Homes Primary Care Pharmacy Targeted Services Community Pharmacy Patient Medication Records 1990s 2000s 1970s 1980s Innovations inPharmacy Services 30th Nov. 2013

  7. Transferring care Clinical Management Plan Verifying Treatment Monitoring Treatment Confirming Outcomes of Treatment 30th Nov. 2013

  8. Profile of Patient’s Characteristics Patient Comprehension/Participation Confirmation of Need Drug History Contra-indications/Interactions Treatment Plan Conformity to Guidelines Individualised Dose, Dose Frequency, Means of Administration Clinical Monitoring Laboratory Markers Adherence to Treatment Verification Confirmationof outcomes Achievement of Treatment Goals Confirmation of Safety Unwanted Symptoms Recorded Adverse Reaction Monitoring 30th Nov. 2013

  9. Documentation Laboratory tests Pharmaceutical care plan Medication Patient Profile Responsibility 30th Nov. 2013

  10. History 1940~1960 Era of Expansion period 1970~1980 Era of Cost containment 1990~ Era of Assessment and Accountability for Health Outcome 30th Nov. 2013

  11. Definition of Pharmacoeconomics The process of identifying, measuring, and comparing the costs, risks, and benefits of programs, services, or therapies To determine which alternative produces the best health outcome for the resource invested Most impactful when making decisions about a population rather than individual “Costs vs. Consequences of Alternatives” 30th Nov. 2013

  12. Micro to Macro Applications with Pharmacoecomomics From Board Room to Bedside Education in safe and effective prescribing practices. AAMC. July 2008. 30th Nov. 2013

  13. Perspective of Pharmacoeconomics Patient perspective Provider perspective Payer perspective Societal perspective Direct medical costs Direct non medical costs Indirect nonmedical costs Intangible costs Opportunity costs Incremental costs After selection of perspective next step cost related measurements 30th Nov. 2013

  14. Application of Pharmacoeconomics Clinical Pharmacy Service Evaluation Determining the value of an existing services Estimating the potential worth of implementing a new service Capturing the value of a “cognitive” clinical intervention Industry-marketing pricing, performance guarantee Managed care – protocols, guidelines, formularies Physicians – individual patient treatment decisions, prescribing, payer-performance Consumer – education, autonomy Government – pricing, approval, formularies, policy Institution – protocol, guidelines, formularies Pharmacist – formularies, protocol, guideline, pharmaceutical care service or program evaluation Drug Therapy Evaluation – Selective the most cost-effective drugs for an organizational formulary Making a decision about an individual patient’s therapy Customizing a patient’s pharmacotherapy 30th Nov. 2013

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