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

Amaia Malet-Larrea (), Estíbaliz Goyenechea, Miguel A. Gastelurrutia, Begoña Calvo, Victoria García-Cárdenas, Juan M. Cabases, Aránzazu Noain, Fernando Martínez-Martínez, Daniel Sabater-Hernández and Shalom I. Benrimoj
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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
Shalom I. Benrimoj: University of Technology Sydney

The European Journal of Health Economics, 2017, vol. 18, issue 9, No 2, 1069-1078

Abstract: 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.

Keywords: Pharmaceutical services; Pharmacists; Medication review; Aged; Cost and cost analysis; Cost-benefit analysis (search for similar items in EconPapers)
JEL-codes: I11 (search for similar items in EconPapers)
Date: 2017
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Citations: View citations in EconPapers (1)

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DOI: 10.1007/s10198-016-0853-7

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