ECONOMIC AND CLINICAL VALUE OF A DESIGNATED ONCOLOGY PHARMACIST IN HEMATO-ONCOLOGY OUTPATIENT CARE: INTEGRATING COST-EFFECTIVENESS, TECHNICAL EFFICIENCY, AND COST SAVING...
Author(s)
Areen Khateeb Alabbasi, Dr1, Shai Cohen, Prof2, Manfred Green, Prof3, Shuli Brammli-Greenberg, Dr4.
1Clalit Health Services, Haifa, Israel, 2Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel, 3School of Public Health, University of Hafia, Haifa, Israel, 4Braun School of Public Health, The Hebrew University of Jerusalem, Jerusalem, Israel.
1Clalit Health Services, Haifa, Israel, 2Bruce Rappaport Faculty of Medicine, Technion – Israel Institute of Technology, Haifa, Israel, 3School of Public Health, University of Hafia, Haifa, Israel, 4Braun School of Public Health, The Hebrew University of Jerusalem, Jerusalem, Israel.
OBJECTIVES: Adverse drug reactions (ADRs), medication errors, and high-cost oncology therapies impose major clinical and economic burdens in hemato-oncology care. We evaluated the economic and clinical value of integrating a designated oncology pharmacist (DPha) into Israeli hemato-oncology outpatient clinics using evidence from a randomized controlled trial, focusing on cost-effectiveness, drug cost savings, and technical efficiency.
METHODS: Adults with hematologic malignancies receiving biological or chemotherapy treatment were randomized 1:1 to comprehensive pharmaceutical care delivered by a DPha versus standard care (n=182; 91/group) and followed for 5 months. Trial-based cost-effectiveness analysis adopted an insurer perspective to quantify intervention-related drug cost savings, technical efficiency gains, and ICERs for ADR prevention and healthcare utilization outcomes. Sensitivity analyses examined uncertainty using bootstrap resampling, pharmacist salary scenarios across 10 countries, and varying drug price assumptions.
RESULTS: The DPha intervention reduced ADR risk from 47.3% to 23.1% (ARR=24.2%; NNT=4.1), yielding an ICER of $434 per ADR avoided at a program cost of $105 per patient. Secondary outcomes favored the intervention, including fewer emergency department visits, hospitalizations, and primary care visits. The pharmacist intercepted 287 medication errors, including 13 potentially severe events, with 94.8% physician acceptance of recommendations. The economic evaluation demonstrated $269,420 net savings after pharmacist costs ($2,960 per patient; $411 per pharmacist hour). Sensitivity analyses confirmed robust cost-effectiveness and cost savings across drug price and pharmacist wage assumptions. Overall, pharmacist integration improved technical efficiency through optimized medication utilization, waste reduction, workflow coordination, and improved patient safety.
CONCLUSIONS: Integrating a DPha into hemato-oncology outpatient care delivers substantial clinical and economic value. The intervention is cost-effective for preventing ADRs, produces significant drug treatment cost savings, and improves technical efficiency without compromising care quality. These findings support broader implementation of oncology pharmacist services as a high-value strategy for improving safety, sustainability, and resource efficiency in cancer care.
METHODS: Adults with hematologic malignancies receiving biological or chemotherapy treatment were randomized 1:1 to comprehensive pharmaceutical care delivered by a DPha versus standard care (n=182; 91/group) and followed for 5 months. Trial-based cost-effectiveness analysis adopted an insurer perspective to quantify intervention-related drug cost savings, technical efficiency gains, and ICERs for ADR prevention and healthcare utilization outcomes. Sensitivity analyses examined uncertainty using bootstrap resampling, pharmacist salary scenarios across 10 countries, and varying drug price assumptions.
RESULTS: The DPha intervention reduced ADR risk from 47.3% to 23.1% (ARR=24.2%; NNT=4.1), yielding an ICER of $434 per ADR avoided at a program cost of $105 per patient. Secondary outcomes favored the intervention, including fewer emergency department visits, hospitalizations, and primary care visits. The pharmacist intercepted 287 medication errors, including 13 potentially severe events, with 94.8% physician acceptance of recommendations. The economic evaluation demonstrated $269,420 net savings after pharmacist costs ($2,960 per patient; $411 per pharmacist hour). Sensitivity analyses confirmed robust cost-effectiveness and cost savings across drug price and pharmacist wage assumptions. Overall, pharmacist integration improved technical efficiency through optimized medication utilization, waste reduction, workflow coordination, and improved patient safety.
CONCLUSIONS: Integrating a DPha into hemato-oncology outpatient care delivers substantial clinical and economic value. The intervention is cost-effective for preventing ADRs, produces significant drug treatment cost savings, and improves technical efficiency without compromising care quality. These findings support broader implementation of oncology pharmacist services as a high-value strategy for improving safety, sustainability, and resource efficiency in cancer care.
Conference/Value in Health Info
2026-09, ISPOR Asia Pacific 2026, Bangkok, Thailand
Value in Health, Volume 55, Issue S1
Code
EE22
Topic
Economic Evaluation
Topic Subcategory
Trial-Based Economic Evaluation
Disease
SDC: Oncology