Abstract
Background: Cardiovascular diseases are the leading cause of death. Pharmacist-led medication review with follow-up might be cost-effective preventing cardiovascular diseases.
Objective: To undertake a cost–utility analysis of the addition of pharmacist-led medication review with follow-up to usual care compared to usual care alone for cardiovascular outpatients.
Materials and methods: A state-transition microsimulation model was built to project outcomes over a lifetime time horizon. Inputs from a cluster randomized controlled trial conducted in primary health care centers in Chile with full-time pharmacists were used. Probabilities were estimated using patient-level data. Utilities and costs associated with each health state were obtained from the literature, whereas the intervention costs were retrieved from the trial. The public third-party payer perspective was used. Uncertainty was evaluated through one-way and probabilistic sensitivity analyses.
Results: For the base case analysis, an incremental cost-effectiveness ratio of $963 per quality-adjusted life-year was observed which was considered cost-effective. The results were robust to sensitivity analyses and were driven by decreased cardiovascular events resulting in lower mortality.
Conclusions: Medication review with follow-up was deemed a cost-effective addition to usual care with low uncertainty.
Objective: To undertake a cost–utility analysis of the addition of pharmacist-led medication review with follow-up to usual care compared to usual care alone for cardiovascular outpatients.
Materials and methods: A state-transition microsimulation model was built to project outcomes over a lifetime time horizon. Inputs from a cluster randomized controlled trial conducted in primary health care centers in Chile with full-time pharmacists were used. Probabilities were estimated using patient-level data. Utilities and costs associated with each health state were obtained from the literature, whereas the intervention costs were retrieved from the trial. The public third-party payer perspective was used. Uncertainty was evaluated through one-way and probabilistic sensitivity analyses.
Results: For the base case analysis, an incremental cost-effectiveness ratio of $963 per quality-adjusted life-year was observed which was considered cost-effective. The results were robust to sensitivity analyses and were driven by decreased cardiovascular events resulting in lower mortality.
Conclusions: Medication review with follow-up was deemed a cost-effective addition to usual care with low uncertainty.
| Original language | English |
|---|---|
| Pages (from-to) | 1406-1414 |
| Number of pages | 9 |
| Journal | Health Policy |
| Volume | 125 |
| Issue number | 11 |
| Early online date | 16 Sept 2021 |
| DOIs | |
| Publication status | Published - Nov 2021 |
Keywords
- Aged
- Cardiovascular system
- Cost-effectiveness
- Drug Monitoring
- Economics
- Pharmacy