Relationship between the number of hospital pharmacists and hospital pharmaceutical expenditure: a macro-level panel data model of fixed effects with individual and time

Abstract

Background: The rapid increase in pharmaceutical expenditure (PE) has been a main problem of global healthcare reform for decades. Previous studies demonstrated that pharmacists play an indispensable role in controlling PE, but macro-research evidence is scarce. Exploring the role of pharmacists from a macro-perspective is essential for pharmacy source allocation with an advantage of extensive applicability over regions. This study aimed to explore the relationship between the number of hospital pharmacists and hospital PE and to provide a macro-perspective evidence to curb the increasing PE and decline unnecessary medications. Methods: Data were extracted from China Health Statistics Yearbook from 2011 to 2018. A panel dataset with 31 provinces from 2010 to 2017 was constructed. Amongst them, 'Number of hospital pharmacists per 1 million of population' (HLPT) was selected as an independent variable, 'Per visit of hospital outpatient pharmaceutical expenditure' (OTPE) and 'Per capita of hospital inpatient pharmaceutical expenditure' (ITPE) were selected as dependent variables, and 'Number of hospital physicians per 1 million of population' (HLPN) and 'Drug price index' (DPI) were applied as control variables. Fixed-effect panel data analysis was performed to evaluate the relationship between the number of hospital pharmacists and hospital PE. Results: HLPT had a significant and negative relationships with OTPE (β 1 = − 0.0893, p = 0.0132) and ITPE (β 1 = − 4.924, p < 0.001). Considering the control variables, the significant and negative relationships with HLPT and OTPE remained unchanged (β 1 = − 0.141, p < 0.001; β 1 = − 4.771, p < 0.001, respectively), indicating that an increase in hospital pharmacist per 1 million of population led to a decrease of ¥474 million ($67.4 million) OTPE and ¥902 million ($128 million) ITPE in 2017. Overall, in 2017, an increase of 1 hospital pharmacist led to a decrease of approximately ¥1 million ($142 thousands) hospital PE nationwide. Conclusion: This study confirmed the negative relationship between hospital pharmacists and hospital PE, indicating that hospital pharmacists might play a significant role in controlling PE. Pharmacists were encouraged to participate in more drug-therapy-related activities, such as medication reconciliation.

The Impacts of National Centralized Drug Procurement Policy on Drug Utilization and Drug Expenditures: The Case of Shenzhen, China

“…Many countries worldwide are facing the challenge of ever-increasing pharmaceutical expenditures [1][2][3][4], and the global pharmaceutical market reached USD 955 billion in 2019 [5]. In China, the total pharmaceutical expenditures increased by 17 times from 1990 to 2009, with an annual growth of 15.2% [6].…”

Comparing knowledge, attitudes, and practices in cardiovascular disease prevention and health promotion between community and hospital pharmacists in Saudi Arabia: A cross-sectional study

“…The current study discovered that the availability of more than one pharmacist per shift increased the positive practices, a phenomenon more prevalent amongst hospital pharmacists than community pharmacists. The availability of pharmacists may vary depending on the number of beds available in hospitals, and it is required to have a minimum of three pharmacists for small hospitals ( Wei et al, 2020 ). The results of the current study showing overwhelmingly positive perspectives and behaviors among hospital pharmacists may be at least partially attributable to this suggested figure.…”

Development of service standards and manpower calculation criteria for hospital clinical pharmacies in South Korea: a survey-based study

“…According to a European study, the UK, which has the highest number of pharmacists per bed, had the highest rate of implementing clinical pharmacy services [ 27 , 28 ]. Moreover, increasing the number of hospital pharmacists allows them to focus on clinical pharmacy service activities, leading to a reduction in pharmaceutical expenditure [ 29 ]. Thus, it is crucial to calculate appropriate clinical pharmacists’ manpower from an economic perspective.…”