title: Effect of medication reconciliation on medication costs after hospital discharge in relation to hospital pharmacy labor costs.
abstract: BACKGROUND
  Medication reconciliation aims to correct discrepancies in medication use between health care settings and to check the quality of pharmacotherapy to improve effectiveness and safety. In addition, medication reconciliation might also reduce costs.
  
  
  OBJECTIVE
  To evaluate the effect of medication reconciliation on medication costs after hospital discharge in relation to hospital pharmacy labor costs.
  
  
  METHODS
  A prospective observational study was performed. Patients discharged from the pulmonology department were included. A pharmacy team assessed medication errors prevented by medication reconciliation. Interventions were classified into 3 categories: correcting hospital formulary-induced medication changes (eg, reinstating less costly generic drugs used before admission), optimizing pharmacotherapy (eg, discontinuing unnecessary laxative), and eliminating discrepancies (eg, restarting omitted preadmission medication). Because eliminating discrepancies does not represent real costs to society (before hospitalization, the patient was also using the medication), these medication costs were not included in the cost calculation. Medication costs at 1 month and 6 months after hospital discharge and the associated labor costs were assessed using descriptive statistics and scenario analyses. For the 6-month extrapolation, only medication intended for chronic use was included.
  
  
  RESULTS
  Two hundred sixty-two patients were included. Correcting hospital formulary changes saved €1.63/patient (exchange rate: EUR 1 = USD 1.3443) in medication costs at 1 month after discharge and €9.79 at 6 months. Optimizing pharmacotherapy saved €20.13/patient in medication costs at 1 month and €86.86 at 6 months. The associated labor costs for performing medication reconciliation were €41.04/patient. Medication cost savings from correcting hospital formulary-induced changes and optimizing of pharmacotherapy (€96.65/patient) outweighed the labor costs at 6 months extrapolation by €55.62/patient (sensitivity analysis €37.25-71.10).
  
  
  CONCLUSIONS
  Preventing medication errors through medication reconciliation results in higher benefits than the costs related to the net time investment.
authors.affiliation: Sint Lucas Andreas Hospital, Department of Hospital Pharmacy, Amsterdam, Netherlands.
authors.forename: Fatma
authors.initials: F
authors.lastname: Karapinar-Çarkit
authors.forename: Sander D
authors.initials: SD
authors.lastname: Borgsteede
authors.forename: Jan
authors.initials: J
authors.lastname: Zoer
authors.forename: Toine C G
authors.initials: TC
authors.lastname: Egberts
authors.forename: Patricia M L A
authors.initials: PM
authors.lastname: van den Bemt
authors.forename: Maurits
authors.initials: M
authors.lastname: van Tulder
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016527:Drug Costs; D005260:Female; D017721:Hospital Costs; D006784:Hospitals, Teaching / Q000191:economics*; D006801:Humans; D008297:Male; D059065:Medication Reconciliation / Q000191:economics*; D008875:Middle Aged; D009426:Netherlands; D010351:Patient Discharge; D010607:Pharmacy Service, Hospital / Q000191:economics*