The economic impact of the pharmacist in heart failure ambulatory care clinics: A scoping review

Introduction Heart failure (HF) is a chronic condition and a leading cause of hospitalization with high rates of mortality. HF is associated with high costs related to hospitalization, medical procedures, treatments, and medications, and is projected to reach $69.8 billion by 2030 in the United States. As pharmacists are being integrated into HF clinics, studies have shown that clinical pharmacy interventions reduce the number of hospitalizations and deaths. While clinical benefits are clear, the economic impact of different pharmacist interventions remains to be proven. Methods We aimed to conduct a scoping review to narratively synthesize the literature describing the costs of clinical pharmacy interventions in ambulatory HF clinics. MEDLINE, Embase, and CINAHL were searched from database inception to May 2024. We searched for articles containing all four key concepts: ambulatory clinic, pharmacist, heart failure, and cost. Results From 189 records identified, we included 10 studies published in English. The presence of a pharmacist in HF clinics or programs showed an overall trend of reduction in costs related to hospitalization and overall health care costs. Additionally, the overview of the literature and methodology of other studies allowed us to identify the variables necessary to establish an economic model. These include the number of patients seen by the pharmacist, type and number of interventions performed, number and costs of hospitalizations, number and costs of health care appointments or visits in and out of the HF clinic, costs of drugs taken per patient, pharmacists' salary, full‐time equivalent of pharmacists, and uptake of guideline‐directed medical therapy (GDMT). Conclusion Based on this scoping review, clinical pharmacy intervention has demonstrated cost reduction, but has not yet been formally evaluated using a cost‐effectiveness or utility design. This review provides the framework required for a future economic study.