(388) Cost savings from pharmacist-led deprescribing in older adults: A real-world economic perspective

Background: : Polypharmacy is common among older adults and is associated with adverse drug events, increased hospitalizations,and rising healthcare costs. Deprescribing- systematically reviewing and discontinuing inappropriate medications- has shown promise in improving outcomes. Despite this, its adoption across healthcare systems remains limited. Pharmacists, due to their medication expertise and patient accessibility , are well positioned to lead deprescribing interventions, particularly in managed care and outpatient settings.

Objective: : To evaluate the cost savings and clinical outcomes associated with pharmacist-led deprescribing interventions among adults aged 65 and older using real-world data from Medicare, EHRs, and pharmacy dispensing systems between 2018 and 2025.

Methods: : This study used a mixed - methods design combining retrospective analysis of Medicare Part D claims, EHRs from managed care clinics, and pharmacy records with predictive economic modeling. Outcomes measured included changes in hospitalizations, emergency department visits, prescription costs, medication adherence, and high-risk medication use before and after pharmacist- led deprescribing. Cost- benefit and cost-effectiveness analyses were conducted , and sensitivity analyses evaluated subpopulation variability.

Results: : Pharmacist-led deprescribing interventions were associated with an average annual cost savings of $1,872 per patient, with 68% of savings attributed to direct medical costs (e.g., reduced hospitalizations and medication expenses) and 32% to indirect savings. Medication- related hospitalizations declined by 32%, and emergency department visits decreased by 28%. Patients also experienced improved adherence rates (18% increase) an a 44% reduction in the use of high risk medications flagged by Beers Criteria. Compared to physician-led models, pharmacist interventions required less time and produced higher patient satisfaction scores.

Conclusions: : Pharmacist -led deprescribing significantly reduced healthcare utilization and costs among older adults in managed care settings. These findings highlight the clinical and economic value of involving pharmacists in medication management and deprescribing efforts. Broader adoption of pharmacist - driven deprescribing- supported by standardized protocols and real-world implementation strategies- could help address the growing burden of polypharmacy and improve care quality for aging populations.

Sponsorship:: None