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Cost analysis and cost-benefit analysis of a medication review with follow-up service in aged polypharmacy patients

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Abstract

Background

Drug related problems have a significant clinical and economic burden on patients and the healthcare system. Medication review with follow-up (MRF) is a professional pharmacy service aimed at improving patient’s health outcomes through an optimization of the medication.

Objective

To ascertain the economic impact of the MRF service provided in community pharmacies to aged polypharmacy patients comparing MRF with usual care, by undertaking a cost analysis and a cost-benefit analysis.

Methods

The economic evaluation was based on a cluster randomized controlled trial. Patients in the intervention group (IG) received the MRF service and the comparison group (CG) received usual care. The analysis was conducted from the national health system (NHS) perspective over 6 months. Direct medical costs were included and expressed in euros at 2014 prices. Health benefits were estimated by assigning a monetary value to the quality-adjusted life years. One-way deterministic sensitivity analysis was undertaken in order to analyse the uncertainty.

Results

The analysis included 1403 patients (IG: n = 688 vs CG: n = 715). The cost analysis showed that the MRF saved 97 € per patient in 6 months. Extrapolating data to 1 year and assuming a fee for service of 22 € per patient-month, the estimated savings were 273 € per patient-year. The cost-benefit ratio revealed that for every 1 € invested in MRF, a benefit of 3.3 € to 6.2 € was obtained.

Conclusion

The MRF provided health benefits to patients and substantial cost savings to the NHS. Investment in this service would represent an efficient use of healthcare resources.

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Acknowledgements

The authors would like to thank all of the pharmacists who participated in the conSIGUE Program.

We also acknowledge the financial support of the Spanish General Council of Official Colleges of Pharmacists and of CINFA Laboratory.

Amaia Malet-Larrea acknowledges the financial support of the Department of Education, Culture and Language Policy of the Basque Government through its Pre-doctoral Fellowship for Research Personnel in Training.

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Authors and Affiliations

  1. Pharmaceutical Technology Department, Faculty of Pharmacy, University of the Basque Country, P. Universidad 7, 01006, Vitoria, Spain

    Amaia Malet-Larrea & Begoña Calvo

  2. Official Pharmacist Association of Guipúzcoa, Prim 2, 20006, San Sebastián, Spain

    Estíbaliz Goyenechea

  3. Pharmaceutical Care Research Group, Faculty of Pharmacy, University of Granada, Campus Universitario de Cartuja, 18071, Granada, Spain

    Miguel A. Gastelurrutia, Aránzazu Noain, Fernando Martínez-Martínez & Daniel Sabater-Hernández

  4. Graduate School of Health, University of Technology Sydney, 15 Broadway, Ultimo, NSW, 2007, Australia

    Victoria García-Cárdenas, Daniel Sabater-Hernández & Shalom I. Benrimoj

  5. Department of Economics, Public University of Navarra, Campus Arrosadía, 31006, Pamplona, Spain

    Juan M. Cabases

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  1. Amaia Malet-Larrea
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  2. Estíbaliz Goyenechea
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  3. Miguel A. Gastelurrutia
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Correspondence to Amaia Malet-Larrea.

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Malet-Larrea, A., Goyenechea, E., Gastelurrutia, M.A. et al. Cost analysis and cost-benefit analysis of a medication review with follow-up service in aged polypharmacy patients. Eur J Health Econ 18, 1069–1078 (2017). https://doi.org/10.1007/s10198-016-0853-7

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  • DOI: https://doi.org/10.1007/s10198-016-0853-7

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