CSHP Benchmarking Report Tracks Rising Hospital Drug Costs and Staffing Pressure

A new national benchmarking report from the Canadian Society of Hospital Pharmacists (CSHP) offers a detailed look at pharmacy workload, staffing and drug costs in Canadian hospitals. Its 2023/24 results show higher median drug costs in two reported areas than in the previous survey cycle, while pharmacist staffing per bed declined. The figures are useful for planning, but they need to be read with the survey’s coverage and measurement limits in view.

What the survey measured

The 2023/24 Hospital Pharmacy in Canada survey report summarizes information from 151 of 259 eligible hospitals with more than 50 acute-care beds, a 58% response rate. The previous 2020/21 survey had a 63% response rate. The report covers multiple dimensions of hospital pharmacy operations; its results are benchmarks from responding institutions, not a complete accounting of every Canadian hospital.

In adult critical care, the median drug cost per admission was $1,406.80, compared with $762.25 in 2020/21—an increase of about 85%. The reported median medicine drug cost per admission was $410.70, up from $258.87. For adult critical care, the median drug cost per patient-day was $118.20. These are medians for specific service areas and denominators, not estimates of total hospital drug spending. They do not, by themselves, explain why costs changed.

Costs and staffing need to be considered together

The report also describes staffing and workload indicators. Pharmacist staffing per bed was lower than in the prior survey cycle, while the number of reported inpatient beds increased by 19%. That combination may prompt local questions about workload, service coverage and how staffing is measured, but it does not establish that one change caused the other. Hospitals differ in case mix, bed configuration, the services counted, and how they organize pharmacy work.

The survey reports paid hours and role mix as additional benchmarking information. Pharmacy technicians and assistants accounted for 7% of reported hours in clinical roles in the survey results. That figure is a description of participating sites, not a recommendation that hospitals should adopt a particular staffing mix. Any change in role allocation has to fit local regulation, competency, supervision and patient-safety requirements.

How hospital leaders can use the findings

CSHP’s October 8, 2026 webinar, “Benchmarking Hospital Pharmacy: Putting Chapter E of the 2023/24 Hospital Pharmacy in Canada Survey Report to Work,” featured presenter Sammu Dhaliwall and makes a recording available through the society’s event page. The session is an opportunity to consider how to interpret the chapter’s benchmarks and limitations—not a substitute for local operational analysis.

Some results require particular caution. Oncology inpatient drug costs were not reported because the response was too limited. Comparisons across survey years can also be affected by changes in participating hospitals and reporting practices. A median can help frame a question, but it is not automatically an appropriate target for a hospital with a different patient population or service model.

For pharmacy teams, the most useful next step is to compare like with like: use the same denominator, time period and program definition, then investigate local changes alongside patient volume, acuity, formulary and service context. Benchmarking can identify where a deeper review may be valuable; it cannot replace that review.

Practice guidance for pharmacists

• Compare costs using consistent service definitions and denominators, such as cost per admission or per patient-day; do not mix measures.
• Interpret survey medians alongside case mix, bed counts, reporting scope and the 58% response rate. They are not staffing standards or universal targets.
• When reviewing staffing, examine paid hours, workload, service coverage and vacancies together rather than relying on a per-bed figure alone.
• Investigate drivers of a local cost change using pharmacy and patient-care data; the survey describes differences but does not establish their causes.
• Assess any technician or assistant role changes against provincial requirements, training, supervision and patient-safety safeguards.
• Use the CSHP report and webinar as benchmarking resources, then document the local assumptions and limitations behind decisions.