Economic impact of prescribing error prevention with computerized physician order entry of injectable antineoplastic drugs

Abstract

are expressed in terms of benefit-to-cost ratio and total benefit. The robustness of the results was assessed through a series of one-way sensitivity analyses. Over 1 year, prescribing error incidence was estimated at 1.5% [1.3-1.7], i.e. 218 avoided prescribing errors. Potential avoidance of hospital stay was estimated at 419 days or 1.9 ± 0.3 days per prescribing error. Cost-benefit analysis could estimate a net benefit-to-cost ratio of 33.3 (€17.34/€0.52) and a total benefit at €16.82 per pharmaceutical analysis or €249,844 per year. The sensitivity analysis showed robustness of results. Our study shows a substantial economic benefit of pharmaceutical analysis and intervention in the prevention of prescribing errors. The clinical pharmacist adds both value and economic benefit, making it possible to avoid additional use of expensive antineoplastic drugs and hospitalization. Computerized physician order entry of antineoplastic drugs improves the relevance of clinical pharmacist interventions, expanding pharmaceutical analysis and also the role of the pharmacist.

A systematic review of approaches for calculating the cost of medication errors

“…Two studies9 28 included a sensitivity analysis within the calculation for costing MEs. There was little evidence of any formal consideration of bias by other researchers across the remaining studies.…”

“…Conversely, Bates et al 17 used a cohort of control patients who suffered no harm to compare costs with those patients who suffered from an ME. Nerich et al 9 justified the choices of inputs into their calculation by asking experts to judge the likelihood of clinical sequelae being attributable to a particular ME. These various approaches demonstrate the difficulty and complexity in determining causality between a specific ME and subsequent events following it.…”

“…A number of studies9 18 19 23 28 30 attempted to calculate the cost of an ME indirectly by estimating the cost reduction from preventing errors following an intervention. The cost of the MEs calculated in this way varied depending on the nature and effectiveness of the intervention in a particular care context.…”

“…ME incorporates prescribing error9 within its definition but is not as broad as the definition for ADE,10 which also includes adverse drug reactions. The definition of MEs used in this review is taken from the European Medicines Agency as ‘A medication error is an unintended failure in the drug treatment process that leads to, or has the potential to lead to, harm to the patient’ 3…”

Specifications of Computerized Provider Order Entry and Clinical Decision Support Systems for Cancer Patients Undergoing Chemotherapy: A Systematic Review

“…The use of computerized physician order entry (CPOE) and the clinical decision support system (CDSS) has been advocated in various studies and reports aimed at medication error reduction, especially in the prescribing phase [7][8][9][10]. Existing evidence suggests that CPOE and CDSS can be effective in reducing medication errors and increasing compliance with standard treatment protocols [11][12][13].…”