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Table 1 Nesbit method for calculating indirect cost benefit[25]

From: Cost-outcome description of clinical pharmacist interventions in a university teaching hospital

Equation 1: Cost avoidance for individual intervention

Probability of an ADE occurring X cost of an ADE[30]OR (0 or 0.01 or 0.1 or 0.4 or 0.6) X €1057

Probability of an ADE occurring

Probability score

Example

No harm expected

0.00

Pharmacist suggests changing patient from esomeprazole to omeprazole exclusively for economic reasons.

Very low

0.01

Patient regularly takes a bisphosphonate, but medication omitted from hospital kardex

Low

0.10

Patient takes an antibiotic twice daily, when recommended dose would be three times daily.

Medium

0.40

Metformin dose not reduced despite patient demonstrating renal impairment.

High

0.60

Patient prescribed amiodarone while currently taking digoxin without any reduction in digoxin dose.

  1. Source Nesbit, T.W. et al.: Implementation and pharmacoeconomic analysis of a clinical staff pharmacist practice model. American journal of health-system pharmacy 58(9), 784–790 (2001).