Int J Pharm Pract 2001:9:23-30
School of International Business, University of South Australia, North Terrace, Adelaide, SA 5000, Australia Ron Donato, MEc, CPA, lecturer Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, University of South Australia Geoff March, BPharm, doctoral candidate Andrew Gilbert, BPharm, PhD, associate professor Department of Public Health, Adelaide University John Moss, MSoc Sci, FCHSE, senior lecturer
Correspondence: Mr Donato ronald.donato@ unisa.edu.au
Original Papers
Cost implications of the delivery of pharmaceutical care services through Australian community pharmacies
RON DONATO, GEOFF MARCH, JOHN MOSS and ANDREW GILBERT
Objective — To conduct a cost analysis of the Community Pharmacy Model Practices project in South Australia.Method — As part of a prospective participatory action research programme, the cost analysis identified the main items of fixed and variable costs and of potential cost savings, and expressed them in a framework to aid decision-making.
Setting — Ten community pharmacy practices in primary care: five provided generalist medication management, two diabetes care, two asthma care, and one wound management. Services were provided to 411 pharmacy patients (median age 75; 70 per cent female) in the community, resident in a range of nursing home and hostel accommodation, or patients in hospital. There was a maximum of 11 months' observation.
Key findings — All the five medication management pharmacies, one of the asthma management pharmacies, and the wound management pharmacy, but neither of the diabetes management pharmacies, were able to generate potential resource savings greater than their total variable costs, so that net resource savings were available to make a contribution to absorbing fixed costs.
Conclusion — The provision of medication management services by community pharmacies working to a well-defined, systematic process of patient care within a primary care setting can be expected to reduce overall direct costs to the health system. Similar findings are likely with wound management in pharmacy care, but the results are less certain for asthma management and diabetes management. These results, when considered in the light of possible gains in survival and quality of life, are of significant interest to policymakers concerned with controlling health system costs.