This study evaluated the cost-avoidance and clinical benefits gained from pharmacist involvement in focused rounding in the cardiovascular intensive care unit (CICU). A pharmacy salary of $25/hour was assumed, and recommendations for added therapy or increased doses of drug therapy were assessed as costs to the department. Pharmacist-recommended and department-accepted interventions related to discontinuing therapy, switching to more cost-effective therapy, or altering the dosage based on creatinine clearance or overdose were assessed in terms of cost-avoidance to the department. Other interventions were collected, but no related cost impact was reported. Overall, 95% of interventions were accepted. Pharmacy labor cost for time invested was $887, whereas the resulting cost-avoidance to the drug budget was $3,106 (avoided drug costs of $3,202 minus increased drug costs of $96). The final cost savings of $2,218 represented a favorable economic outcome. Other, clinical benefits were derived from focused rounding in the CICU. The authors conclude that pharmacist rounding in the CICU can lead to improved drug therapy and save enough money to offset the cost of the service.