Cost-Effectiveness Analysis of a Pharmacy Asthma Care Program in Australia
A pharmacy asthma care program in Australia, which included specific education on asthma and asthma medication, trigger factors, use of inhalers, and medication adherence, as well as goal setting and patient review aspects, assessed the impact of a community pharmacy asthma service on the severity of patients’ asthma over 6 months. Data from this study were used to estimate the cost effectiveness of the program.
The intervention population was compared with a control population and results at 6 months were included in a Markov model in order to estimate the cost effectiveness over 5 years from the perspective of the Australian healthcare system. The model had a cycle length of 6 months and included transition probabilities for switching between classes of severity of asthma, the costs of asthma treatment and program delivery, and utility values for a patient’s quality of life with asthma. Costs were Australian dollars ($A), year 2006 values, and both costs and benefits were discounted at a rate of 5% per annum.
Over the 5 years following an initial review, the program generated 0.131 additional quality-adjusted life-years (QALYs), at an additional net cost of $A623 if annual reviews were required to maintain asthma improvements (annual review scenario) or $A376 if annual reviews were not required (no annual review scenario), resulting in costs per QALY gained of $A4753 and $A2869, respectively.
The program appears to be cost effective compared with no program, whether or not annual reviews were required to maintain improvements and under a range of other assumptions. Current evidence suggests that the pharmacy asthma care program should be implemented and funded for the treatment of adults with asthma in Australia.
KeywordsAsthma Severe Asthma Asthma Medication Mild Asthma Moderate Asthma
The authors would like to acknowledge Mr Fred Zmudzki for his assistance in constructing the economic model.
This work would not have been possible without the group of pharmacy practice respiratory researchers from across the nation working together; they and the pharmacists who joined in the vision are the reason this project was such a success.
This work was funded by the Australian Department of Health and Ageing as part of the 3rd community pharmacy agreement. The funding source had no part in the design or reporting of the study.
The authors have no conflicts of interest that are directly relevant to the content of this study.
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