Hospital Pharmacy - May 2017 - 357

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HPXXXX10.1177/0018578717715357Hospital PharmacyVanGalder et al.

Article
Hospital Pharmacy
2017, Vol. 52(5) 357-360
© The Author(s) 2017
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https://doi.org/10.1177/0018578717715357
DOI: 10.1177/0018578717715357
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Pharmacists' Knowledge of the
Cost of Laboratory Testing
Keni VanGalder1, Tracey L. Mersfelder1, and Kali VanLangen1

Abstract
Purpose: The objective of this study was to ascertain baseline knowledge of pharmacists and pharmacy residents concerning
the cost of laboratory tests for monitoring medications, and to determine whether an educational session delivered to
pharmacy residents improves their knowledge of these costs. Methods: An online survey was provided to pharmacists
and pharmacy residents, testing their knowledge of 15 common laboratory tests used to monitor the safety and efficacy of
medications. One of the researchers presented a lecture to all pharmacy residents that detailed individual laboratory costs;
after that, the researchers delivered a follow-up survey to assess the effectiveness of the educational session. Results:
Baseline knowledge of pharmacists showed that greater than 64% of the responses were more than 30% away from the actual
cost of the laboratory test for all 15 tests. Baseline knowledge of pharmacy residents showed that greater than 58% of the
responses were more than 30% away from the actual cost of the laboratory test for each individual test. Although there was
no statistically significant improvement in individual cost prediction after the educational session, 2 laboratory values showed
improvement in margins of error post intervention: alanine aminotransferase/aspartate aminotransferase and lipids (P = .008
and .014, respectively). Conclusions: Pharmacists and pharmacy residents poorly predicted the costs of common laboratory
tests. A brief lecture discussing the cost of laboratory tests demonstrated minor improvement in pharmacy residents'
knowledge of the costs reviewed. Pharmacists need to be educated on the cost of laboratory tests to better understand the
profession's contribution to health care expenditures.
Keywords
health care costs, laboratory, pharmacist
There has been a persistent rise in the cost of health care in
the United States. Hospital expenditures rose from $933.5
billion to $971.8 billion (an increase of 4.1%) in 2014.1 A
component of the growth in expenditures is the laboratory
testing ordered. The cost of any single laboratory test is not
staggering; but because of the volume of laboratory testing
ordered for each patient every day, the total impact can be
substantial, especially when serial levels are followed over a
period of time. In 2008, the cost of medical diagnosis, including the laboratory testing, accounted for $250 billion in the
United States, which is roughly 10% of all medical costs.2
Several studies have shown that physicians, medical residents, and medical students are unaware of the economic
impact they have when ordering frequent laboratory tests.3-10
Starting as early as 1976 and as recently as 2014, studies
have repeatedly demonstrated that health care personnel lack
knowledge regarding the costs of laboratory tests.
The health professional overlooked in all of these studies
is the pharmacist. Pharmacists may be contributing to the
rise in costs, and they may be unaware of their role in the
mounting expenses related to drug monitoring. The pharmacists' scope of practice is expanding under protocols and collaborative practice agreements regarding their ability to

order laboratory tests for monitoring the efficacy and toxicity
of medications. It is not known whether pharmacists are
aware of the costs associated with monitoring drug therapy.
The objective of this study was to determine baseline knowledge of pharmacists and pharmacy residents in regard to the
costs associated with having laboratory tests performed. In
addition, this study endeavored to determine whether an education session delivered to pharmacy residents improved
their baseline knowledge of these costs.

Methods
Study Population
All pharmacists who perform pharmacokinetic services at 9
participating hospitals in a limited region of a Midwest state
and all pharmacy residents in this same region enrolled in a
1

Ferris State University, Grand Rapids, MI, USA

Corresponding Author:
Tracey L. Mersfelder, College of Pharmacy, Ferris State University, 25
Michigan Street NE, Grand Rapids, MI 49503, USA.
Email: TraceyMersfelder@ferris.edu

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