International Journal of Clinical Pharmacy

, Volume 39, Issue 4, pp 750–758 | Cite as

Cost analysis for the implementation of a medication review with follow-up service in Spain

  • Aranzazu Noain
  • Victoria Garcia-CardenasEmail author
  • Miguel Angel Gastelurrutia
  • Amaia Malet-Larrea
  • Fernando Martinez-Martinez
  • Daniel Sabater-Hernandez
  • Shalom I. Benrimoj
Research Article


Background Medication review with follow-up (MRF) is a professional pharmacy service proven to be cost-effective. Its broader implementation is limited, mainly due to the lack of evidence-based implementation programs that include economic and financial analysis. Objective To analyse the costs and estimate the price of providing and implementing MRF. Setting Community pharmacy in Spain. Method Elderly patients using poly-pharmacy received a community pharmacist-led MRF for 6 months. The cost analysis was based on the time-driven activity based costing model and included the provider costs, initial investment costs and maintenance expenses. The service price was estimated using the labour costs, costs associated with service provision, potential number of patients receiving the service and mark-up. Main outcome measures Costs and potential price of MRF. Results A mean time of 404.4 (SD 232.2) was spent on service provision and was extrapolated to annual costs. Service provider cost per patient ranged from €196 (SD 90.5) to €310 (SD 164.4). The mean initial investment per pharmacy was €4594 and the mean annual maintenance costs €3,068. Largest items contributing to cost were initial staff training, continuing education and renting of the patient counselling area. The potential service price ranged from €237 to €628 per patient a year. Conclusion Time spent by the service provider accounted for 75–95% of the final cost, followed by initial investment costs and maintenance costs. Remuneration for professional pharmacy services provision must cover service costs and appropriate profit, allowing for their long-term sustainability.


Community pharmacy Cost analysis Implementation Medication review Professional pharmacy services Spain Sustainability 



This study was funded by Cinfa Laboratories.

Conflicts of interest

All the authors have declared they have no conflict of interest.

Availability of data and materials

The data that support the findings of this study are available on request from the corresponding author (VGC). The data are not publicly available due to relevant data protection laws.

Supplementary material

11096_2017_454_MOESM1_ESM.docx (97 kb)
Supplementary material 1 (DOCX 97 kb)


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Copyright information

© Springer International Publishing 2017

Authors and Affiliations

  • Aranzazu Noain
    • 1
  • Victoria Garcia-Cardenas
    • 2
    Email author
  • Miguel Angel Gastelurrutia
    • 1
  • Amaia Malet-Larrea
    • 3
  • Fernando Martinez-Martinez
    • 1
  • Daniel Sabater-Hernandez
    • 2
  • Shalom I. Benrimoj
    • 2
  1. 1.Pharmaceutical Care Research Group, Faculty of PharmacyUniversity of GranadaGranadaSpain
  2. 2.Graduate School of HealthUniversity of Technology SydneySydneyAustralia
  3. 3.Pharmaceutical Technology Department, Faculty of PharmacyUniversity of the Basque CountryVitoriaSpain

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