Cost-Effectiveness of Clinical Pharmacist Integration in Hemato-Oncology Unit: A Randomized Controlled Trial
Author(s)
Areen Khateeb Alabbasi, Phd.
Areen.Alabbassi, University of Haifa, Haifa, Israel.
Areen.Alabbassi, University of Haifa, Haifa, Israel.
OBJECTIVES: While the clinical benefits of pharmacist-led interventions in oncology are increasingly recognized, their cost-effectiveness remains insufficiently understood. This study evaluated the cost-effectiveness of integrating a clinical pharmacist into the care team of a hemato-oncology outpatient clinic, assessing both clinical and economic outcomes compared to standard care.
METHODS: A cost-effectiveness analysis (CEA) was conducted alongside a parallel, single-center, randomized controlled trial of 182 patients with hematologic malignancies (1:1 randomization). The intervention group received standard care augmented by a designated pharmacist providing medication reviews, patient counseling, and physician recommendations over a 4-month period. The control group received standard care without any pharmacist involvement . The primary outcome was the incidence of adverse drug reactions (ADRs), with secondary outcomes including family physician visits, emergency department visits, and unplanned hospitalizations. The CEA adopted a healthcare system perspective. ICER was calculated based on costs and ADRs avoided. One-way and probabilistic sensitivity analyses were conducted to assess robustness.
RESULTS: The intervention reduced the proportion of patients with at least one ADR from 47.3% to 23.1% (hazard ratio 0.38, 95% CI: 0.23-0.65; p<0.001). Family physician visits were significantly reduced (hazard ratio 0.67, 95% CI: 0.50-0.88). The intervention resulted in net savings of approximately $396 per pharmacist hour and an ICER of $444 per ADR avoided. Probabilistic sensitivity analysis indicated a high probability (>85%) that the intervention is cost-effective at a willingness-to-pay threshold of $500 per ADR avoided.
CONCLUSIONS: Integrating a clinical pharmacist into hemato-oncology outpatient care significantly reduces ADR incidence and lowers healthcare utilization. The intervention is cost-effective under standard thresholds and supports broader adoption of pharmacist-led oncology services to enhance safety and economic efficiency
METHODS: A cost-effectiveness analysis (CEA) was conducted alongside a parallel, single-center, randomized controlled trial of 182 patients with hematologic malignancies (1:1 randomization). The intervention group received standard care augmented by a designated pharmacist providing medication reviews, patient counseling, and physician recommendations over a 4-month period. The control group received standard care without any pharmacist involvement . The primary outcome was the incidence of adverse drug reactions (ADRs), with secondary outcomes including family physician visits, emergency department visits, and unplanned hospitalizations. The CEA adopted a healthcare system perspective. ICER was calculated based on costs and ADRs avoided. One-way and probabilistic sensitivity analyses were conducted to assess robustness.
RESULTS: The intervention reduced the proportion of patients with at least one ADR from 47.3% to 23.1% (hazard ratio 0.38, 95% CI: 0.23-0.65; p<0.001). Family physician visits were significantly reduced (hazard ratio 0.67, 95% CI: 0.50-0.88). The intervention resulted in net savings of approximately $396 per pharmacist hour and an ICER of $444 per ADR avoided. Probabilistic sensitivity analysis indicated a high probability (>85%) that the intervention is cost-effective at a willingness-to-pay threshold of $500 per ADR avoided.
CONCLUSIONS: Integrating a clinical pharmacist into hemato-oncology outpatient care significantly reduces ADR incidence and lowers healthcare utilization. The intervention is cost-effective under standard thresholds and supports broader adoption of pharmacist-led oncology services to enhance safety and economic efficiency
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE239
Topic
Economic Evaluation
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology