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Role of pharmacists in curtailing cost of drug therapy and poor patient treatment

"Pharmacists have the potential to play a greater role in the management of chronic illnesses and make considerable savings in healthcare costs"

Pharmacy is the clinical health science that links medical science with chemistry and it is charged with the discovery, production, disposal, safe and effective use, and control of medications and drugs.

A pharmacist, also known as a chemist or a druggist, is a health professional who specializes in the preparation, properties, effects, and use of medicines. A pharmacist provides pharmaceutical care to patients and basic primary health care services.

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The role of a pharmacist has evolved significantly in recent decades. The traditional activities of the profession mainly focused on the dispensing and sourcing of medications, while collaboration with other healthcare professionals was somewhat inadequate. Nowadays, pharmacists also make sure the rational and cost-effective use of medicines, stimulate healthy living, and develop clinical outcomes by actively winning in direct patient care and working together with many healthcare disciplines. With this expanding room of drill, pharmacists are being recognized as key constituents in providing personalized patient care as part of interprofessional healthcare teams.

Money spent on medicines and managing medication-related problems continues to grow. Global healthcare outflow is accelerating at an unjustifiable rate. The high occurrence of medication errors and wrong prescription is a major issue within healthcare systems, and can often contribute to adverse drug events, many of which are escapable. As a result, there is a huge opportunity for pharmacists to have a significant impact on reducing healthcare costs, as they have the expertise to detect, resolve, and prevent medication errors and medication-related problems.

Pharmacists can add to substantial healthcare savings across a range of settings.

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As the universal population ages, healthcare organizations are confronted with the increasing liability of long-lasting diseases and polypharmacy among older adults, the increased number of medicines being consumed by the elderly, as well as the mounting cost of newer pharmacotherapies, has intensified the pressure on healthcare organizations to identify and implement cost-control measures. Pharmacists have a major role in dropping costs by critically revising the pharmacotherapy of multimorbid-aged patients. The reduction of wrongly prescribed medicines not only produces savings in the cost of each medicine but also reduces the risk of adverse drug events (ADEs) that often contribute to prolonged and expensive hospital admissions.

In this field, pharmacists can have a major impact on healthcare decision-makers about the better allocation of resources and expenditure, to optimize population health from the use of medicines. With their unique knowledge of medicines, pharmacists are central figures in decreasing healthcare expenditure through cost savings on medicines and cost avoidance. Cost savings allude to reductions in current spending due to changes in the expense on a patient’s treatment, e.g. switching from intravenous to oral therapy where appropriate.

Medication errors and inappropriate prescription are recognized as major problems, both clinically and economically, for the healthcare system. They can contribute to adverse drug reactions (ADRs) and ADEs, especially in elderly patients, and can have a major impact on patient morbidity and mortality. ADEs can result in increased healthcare utilization, as well as extend hospital admissions, hence incurring further medical costs.

Pharmacists have proved a positive effect in preventing medication errors and limiting inappropriate prescribing, thus reducing healthcare costs by preventing hospital admission or reducing hospital length of stay.

The long-established image of community pharmacists has been based on a transactional model, primarily focused on the preparation, dispensing, and supply of medicines. However, this profession has transformed considerably in recent times, and faces further radical changes as it moves toward providing services and playing a greater role in health promotion and disease prevention. Community pharmacists are one of the most accessible healthcare providers and hence are in a unique position to provide patient-focused primary healthcare service to their community.

Most primary care physicians do not have enough time to provide all of the preventive and chronic disease services that patients require, and this is where pharmacists can play a vital role, as they have the right expertise to provide high-quality patient-centered health care.

Pharmacists have the potential to play a greater role in the management of chronic illnesses and make considerable savings in healthcare costs. As frontline healthcare professionals, community pharmacists are in contact with this patient cohort regularly, are specially trained to reduce disease severity, monitor medication therapy to achieve desired clinical effects, reduce adverse health events, and can make recommendations to patients or prescribers regarding pharmacotherapy where appropriate. Good medication adherence correlates with positive health outcomes, it is estimated that between 20 to 50 percent of patients in developed countries may be non-adherent with their medications. Non-adherence is associated with potential disease progression, pharmacotherapeutic failure, and hospitalization.

Pharmacists safeguard their patients, especially the elderly, from potentially inappropriate use of OTC medicines. Pharmacists often provide advice or non-pharmacological approaches as first-line solutions, hence saving on the cost of purchasing an OTC item unnecessarily.

Community pharmacy minor ailment schemes can save physician time spent with minor illnesses and enables them to focus on patients with more complex medical issues. This may contribute to shorter waiting times, unclogged GP surgeries, and enhanced patient access to services.

Hospital pharmacists have had a major influence on the advancement of pharmacy practice in recent decades.

In many countries, hospital pharmacists have expanded their roles beyond the dispensary, and now routinely provide clinical pharmacy services at the ward level, which includes reviewing patients’ medications and advising other healthcare professionals about pharmacotherapy.

When delivered as a core clinical service, pharmacist-managed medication therapy has been associated with reduced medication errors, ADRs, mortality, and LOS.

Pharmacists contribute to reductions in costs in a wide variety of healthcare settings. High-quality studies would act as viable decision tools in choosing what clinical pharmacy services should be implemented. Lastly, while the economic effect of clinical pharmacy services is important, it is not the only aspect that must be taken into consideration. The impact that the service has on clinical and humanistic outcomes is also of great significance and must be considered when selecting what pharmacist-provided patient care services could be developed in the future.


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