Pharmacoeconomic effect of compliance with pharmacist's intervention based on cancer chemotherapy regimens: a cohort study

Abstract

Background: It is important for pharmacists to manage cancer chemotherapy regimens in order to achieve safe treatment. We examined whether there was a useful pharmacoeconomic benefit of compliance the exclusion criteria of neutropenia, and the importance of a pharmacist's intervention was considered.

Methods: A prospective observational cohort study was conducted at a community-based medical center. Among 374 patients who received chemotherapy between April 2010 and March 2011, 108 patients developed neutropenia and pharmacists recommended suspension of chemotherapy. These patients were divided into a group in whom chemotherapy was suspended (complying group) and a group in whom it was continued (non-complying group). Then the relative dose intensity (RDI) was compared between the two groups, and medical expenses related to the treatment of neutropenia (neutropenia-related costs: NRC) were compared. Analysis was carried out from the perspective of the health insurance provider, so only the direct medical costs were evaluated.

Results: There was a significant difference of the RDI between a complying group (85.2 ± 10.0%) and a non-complying group (79.3 ± 15.0%) (P = 0.021). The average NRC per patient showed a significant difference between the two groups (complying group: 1,944 ± 412 dollars, non-complying group: 4,394 ± 837 dollars, P = 0.044). The economic effect over one year was 54,205 dollars.

Conclusion: The present findings suggest that ensuring compliance with chemotherapy regimens (including the criteria for neutropenia) is effective from a pharmacoeconomic perspective. Accordingly, pharmacists should intervene as required to improve regimen compliance.

Keywords: Pharmacist intervention; Pharmacoeconomics; Regimen management.

Figure 1

Chemotherapy flow and regimen checking by pharmacists. The pharmacist performed the regimen check and patients were classified into the complying group and the non-complying group depending on whether the doctor followed the pharmacist’s advice.