Open Access Highly Accessed Research article

Cost-outcome description of clinical pharmacist interventions in a university teaching hospital

James Gallagher14*, Stephen Byrne1, Noel Woods2, Deirdre Lynch3 and Suzanne McCarthy1

Author Affiliations

1 Clinical Pharmacy Research Group, School of Pharmacy, University College Cork, Cork, Ireland

2 Centre for Policy Studies, University College Cork, Cork, Ireland

3 Pharmacy Department, Cork University Hospital, Cork, Ireland

4 HRB Clinical Research Facility at UCC, Mercy University Hospital, Cork, Ireland

For all author emails, please log on.

BMC Health Services Research 2014, 14:177  doi:10.1186/1472-6963-14-177

Published: 17 April 2014



Pharmacist interventions are one of the pivotal parts of a clinical pharmacy service within a hospital. This study estimates the cost avoidance generated by pharmacist interventions due to the prevention of adverse drug events (ADE). The types of interventions identified are also analysed.


Interventions recorded by a team of hospital pharmacists over a one year time period were included in the study. Interventions were assigned a rating score, determined by the probability that an ADE would have occurred in the absence of an intervention. These scores were then used to calculate cost avoidance. Net cost benefit and cost benefit ratio were the primary outcomes. Categories of interventions were also analysed.


A total cost avoidance of €708,221 was generated. Input costs were calculated at €81,942. This resulted in a net cost benefit of €626,279 and a cost benefit ratio of 8.64: 1. The most common type of intervention was the identification of medication omissions, followed by dosage adjustments and requests to review therapies.


This study provides further evidence that pharmacist interventions provide substantial cost avoidance to the healthcare payer. There is a serious issue of patient’s regular medication being omitted on transfer to an inpatient setting in Irish hospitals.

Hospital pharmacy; Adverse drug events; Health care economics; Ireland; Clinical pharmacy services; Cost avoidance