The Evolution

It is useful to look at the evolution of drug information practice from the perspective of drug information centers and of practicing pharmacists. One report describes the decline in number of drug information centers nationally with the number of drug information pharmacists and other personnel being the lowest in 30 years., A total of 81 drug information centers were identified in this survey, although there are some existing centers missing from this list and there has been some controversy at meetings of drug information practitioners regarding some centers being excluded because of the definition of drug information centers that is used. Another source of drug information center locations, the 2004 Red Book, lists a total of 112 drug information centers nationally. Determining the accurate number is difficult. The centers are identified for these two sources through various listings that have developed over the years, but no agency or organization is responsible for maintaining a list. Well-defined criteria are not established for using the titles of drug information center/service. Some centers have specialized in a particular area of drug information and their name may reflect that specific function (e.g., Center of Drug Policy). Likewise, these lists only address drug information centers listed in the United States or Puerto Rico, and not those that have been created internationally. They also exclude centers/services provided by the pharmaceutical industry. Therefore, depending on how one would define a drug information center, the number may actually be higher.

A recent survey (2003) describes the current status of drug information centers compared to past years. For several years, funding for drug information centers has been provided primarily by hospitals or medical centers (73% in 2003, 82% in 1992, and 88% in 1986), or colleges or universities (37% in 2003, 35% in 1992, and 32% in 1986). However, there was a statistically significant decrease in the percentage of drug information centers funded by hospitals between 1986 and 2003. This decrease could be attributed to the economic constraints faced by the health care system in the last several years.

Drug information pharmacists working in centers appear to be better trained than those in the past and a larger percentage have a doctor of pharmacy degree (71% in 2003, and 42% in 1986 and 1992). The number of individuals who have completed a drug information residency, fellowship, or MS degree program has also increased in recent years (29% in 2003 and 11% in 1992).

In addition to the responsibility of answering questions, the most commonly reported services in 2003 were preparation of newsletters (80%) and participation in pharmacy and therapeutics committee activities (79%). Education appears to be a growing area of responsibility. Forty-one percent of respondents considered education to be their primary goal. There was an increase in the percentage of drug information centers that participated in any type of residency program training (83% in 2003) compared to 1976, 1980, 1986, and 1992, in which the number of centers that participated in any residency program ranged from 54 to 66%. There was also a larger number of drug information centers used for experiential training as part of a doctor of pharmacy program (95% in 2003 compared to 59% in 1992). outlines several services that are typically provided by drug information centers.

There have been a few studies that have described the economic benefit of maintaining a drug information center or related activity in an academic institution or hospital. One such study examined the economic impact of drug information services responding to patient-specific requests. The resultant benefit/cost ratio was found to be 2.9:1 to 13.2:1. Most of the cost savings resulted from decreased need for monitoring (e.g., laboratory tests) or decreased need for additional treatment related to an adverse effect. Another study examined the drug cost avoidance and revenue associated with the provision of investigational drug services, which are many times a responsibility of a drug information center. The annualized drug cost avoidance plus revenue was $2.6 million. Although the cost avoidance varied with the type of study and disease category involved, overall, the investigational drug service accounted for substantial drug cost avoidance. These types of studies are becoming increasingly important in an era of cost containment.