Cost-benefit analysis of a clinical pharmacist-managed medication assistance program in a renal transplant clinic

Medicare pays for 80% of the cost of immunosuppressant agents needed within the first 3 years of solid organ transplantation; however, many patients c annot afford the remaining 20%. Furthermore, many patients who are beyond 3 years post-transplantation and have prescription coverage cannot afford th e co-payment for these medications. Other patients may not be able to affor d their medications due to limited or no insurance coverage. The Medical Co llege of Georgia (MCG) has been giving immunosuppressant medications to ren al transplant patients if they cannot afford to pay for them. To assist MCG with drug cost for medications and maintain quality care for renal transpl ant patients, a clinical pharmacist-managed medication assistance program w as implemented to procure immunosuppressants from pharmaceutical manufactur ers. Methods: All patients enrolled in medication assistance programs from 1 Jan uary 1998 through 31 December 1998 were included in this analysis. Medicati on acquisition costs with and without Medicare reimbursement and the cost o f implementing the clinical pharmacist-managed medication assistance progra m were used to determine the value of implementing this service. Results: Sixty-one patients were enrolled in manufacturers' assistance prog rams and a net cost avoidance of $124,793 was realized for the year of the program (benefit-to-cost ratio of 7.5:1). Assuming that the hospital collec ted the maximum amount allowed for patients receiving Medicare benefits, a cost avoidance of $69,233 was calculated (benefit-to-cost ratio of 4.16:1). Conclusions: A clinical pharmacist-managed medication assistance program in a renal transplant clinic produced substantial cost savings over this 1-ye ar study period. For each dollar spent in pharmacist's time, a minimum of $ 4 was returned to the institution.