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

Author

Listed:
  • Amaia Malet-Larrea

    (University of the Basque Country)

  • Estíbaliz Goyenechea

    (Official Pharmacist Association of Guipúzcoa)

  • Miguel A. Gastelurrutia

    (University of Granada)

  • Begoña Calvo

    (University of the Basque Country)

  • Victoria García-Cárdenas

    (University of Technology Sydney)

  • Juan M. Cabases

    (Public University of Navarra)

  • Aránzazu Noain

    (University of Granada)

  • Fernando Martínez-Martínez

    (University of Granada)

  • Daniel Sabater-Hernández

    (University of Granada
    University of Technology Sydney)

  • Shalom I. Benrimoj

    (University of Technology Sydney)

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.

Suggested Citation

  • Amaia Malet-Larrea & Estíbaliz Goyenechea & Miguel A. Gastelurrutia & Begoña Calvo & Victoria García-Cárdenas & Juan M. Cabases & Aránzazu Noain & Fernando Martínez-Martínez & Daniel Sabater-Hernández, 2017. "Cost analysis and cost-benefit analysis of a medication review with follow-up service in aged polypharmacy patients," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(9), pages 1069-1078, December.
    • Handle: RePEc:spr:eujhec:v:18:y:2017:i:9:d:10.1007_s10198-016-0853-7
    DOI: 10.1007/s10198-016-0853-7
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    References listed on IDEAS

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    1. Pinto-Prades, Jose Luis & Loomes, Graham & Brey, Raul, 2009. "Trying to estimate a monetary value for the QALY," Journal of Health Economics, Elsevier, vol. 28(3), pages 553-562, May.
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    5. Takeru Shiroiwa & Yoon‐Kyoung Sung & Takashi Fukuda & Hui‐Chu Lang & Sang‐Cheol Bae & Kiichiro Tsutani, 2010. "International survey on willingness‐to‐pay (WTP) for one additional QALY gained: what is the threshold of cost effectiveness?," Health Economics, John Wiley & Sons, Ltd., vol. 19(4), pages 422-437, April.
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    More about this item

    Keywords

    Pharmaceutical services; Pharmacists; Medication review; Aged; Cost and cost analysis; Cost-benefit analysis;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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