공중보건약사 활용의 경제성 평가

Abstract

This study was to evaluate economic impact of the Public Health Pharmacist, in a societal perspective. We setthe work scope of Public Health Pharmacist as supporting of filling a prescription in public hospitals, medicationcounseling and night time pharmacist in health center. Clinical outcomes of Public Health Pharmacist included drugcompliance increase, social hospitalization reduction, and late night pharmaceutical accessibility improvement. And asresult of drug compliance increase, inappropriate medication discontinuation, subsequent drug-related morbidity andmortality reduction might take place. Economic outcomes included cost savings from direct medical cost reduction suchas medication and healthcare utilization and indirect cost of family members and care-givers. Input costs for Public HealthPharmacist included payroll costs, indirect expenses for the personnel, health center operating expenses for night time,medical material expenses, and telephone and visiting expenses for medication counseling service. Model parameters foroutcomes were derived from published literatures, and costs were from literatures and health insurance statistical data inKorea. Annual costs and benefits were estimated in the year of 2018. We assumed that 1,347 public health pharmacistwould be in charge, and their service meet the need of over 65 population fully, and that of the whole population in Koreain case of the “public night pharmacy.” Cost for Public Health Pharmacist was ￦70,974,390,845 per year and benefit for PublicHealth Pharmacist was ￦180,167,236,698 per year. Benefit-to-cost ratio was 2.538:1 and net benefit was ￦109,192,845,853per year. However, in a certain condition in sensitivity test, it was showed that benefit of Public Health Pharmacist mayreduced considerably. This implied that the cost effectiveness and economic validity of Public Health Pharmacist dependon change of medical care utilization behaviors people. In conclusion, the economic validity of Public Health Pharmacistwas at least neutral under several alternative scenarios.