Pharmacist Care a Grand Slam for Anticoagulation

New research shows costs go down and quality goes up when pharmacists manage anticoagulation services.

A new study offers further evidence that pharmacists’ systematic approach to warfarin management is unmatched by traditional, physician-centered care.

In a report on the findings, Pharmacy Practice News quoted the study’s lead author, Deanne L. Hall, PharmD: “A lot of us have thought the case was rested over the advantage of pharmacist-managed anticoagulation services,” she said. “Pharmacists are already well-versed in warfarin pharmacology and all its potential drug-drug and disease-state interactions.”

The complex, time intensive work of warfarin management is burdensome for many physicians operating in a standard care model. Incorporating pharmacists into the mix relieves some of that pressure, allowing physicians to focus on other patients. Although these benefits were well known to Dr. Hall and her colleagues, fewer studies have confirmed the potential cost savings of pharmacist-managed anticoagulation care.

In their retrospective analysis of 175 patients at the University of Pittsburgh Medical Center (UPMC), the team aimed to identify a precise dollar amount. Comparing both financial and therapeutic outcomes, they matched medical records and claims data of patients who received standard warfarin management from a physician against those who participated in UPMC’s pharmacist-managed anticoagulation service.

Pharmacist-managed care yielded nearly $700,000 in overall savings. Patients in the intervention group experienced significantly fewer adverse events, hospital admissions, and emergency department visits. They also spent more time in therapeutic range (73% vs 61.3%), based on international normalized ratio readings.

“Pharmacist-managed anticoagulation leads to reduced health care expenditure, while improving therapeutic outcomes,” Dr. Hall concluded. She hopes the promising results will help health plans and practitioners work together to establish a sound business model that includes reimbursement for pharmacists.