BACKGROUND: Clinical Pharmacists interact with health professionals and patients to optimize patient care, improve the quality of disease management. Furthermore, medication use is a dynamic process that needs active follow-up by the clinical pharmacist to obtain enhanced outcomes.

OBJECTIVE: The current study aims to evaluate the economic impact of the clinical pharmacists' dosage-adjustment intervention provided at the Ministry of Health hospitals in Alexandria, Egypt.

METHOD: A multi-center retrospective study was conducted. Clinical pharmacists' interventions related to dose adjustment were identified using record review. The setting included sixteen Ministry of Health hospitals, where clinical pharmacy services were provided, between 1^st January 2018 and 30th June 2019. Drug costs were calculated based on defined daily doses and official prices in the Egyptian tender. Benefits were calculated by subtracting the positive from negative benefits. Benefits were expressed in 2022 USD.

RESULTS: A total of 8,000 interventions concerning dosing regimen were documented by the Clinical pharmacists during the study period. The most frequent actions were recommendations for dose adjustment n=7,454 (93%), compared to only 546 (7%) interventions regarding changing dose intervals. Dose adjustment was the most frequent intervention in ICU, inpatient department, and burn units (n=3,963, n= 3,008, and n= 213) respectively, but the second frequent intervention observed in outpatient clinics following recommendations regarding adding a new drug for the untreated condition. The acceptance rate was significantly higher in interventions related to dose adjustment than any other type of intervention. The mean benefit was estimated at USD 150.21 (±1,123.58). Total positive benefits from the dose-adjustment interventions during the study period were USD 1,014,859.20, while total negative benefits were USD 134,131.64. The net benefit was USD 880,727.56.

CONCLUSION: Besides their impact on the quality of patient treatment, dose-adjustment clinical pharmacist's interventions had a positive economic impact. Such services are worth expanding in all Egyptian hospitals.