Cost-Effectiveness Analysis of a Pharmacist-Led Medication Therapy Management Program: Hypertension Management
| Autor: | Danny Quach, Tiffany Scott-Horton, Daniel R. Touchette, Jessica J. Tilton, Julie Jun, Bob G. Schultz |
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| Rok vydání: | 2021 |
| Předmět: |
Medication Therapy Management
Cost effectiveness Cost-Benefit Analysis Pharmacist Pharmacists Pharmacotherapy Medication therapy management Health care Humans Medicine Antihypertensive Agents health care economics and organizations Reimbursement business.industry Health Policy Public Health Environmental and Occupational Health Health Care Costs Cost-effectiveness analysis medicine.disease Markov Chains Stroke Cardiovascular Diseases Hypertension Insurance Health Reimbursement Observational study Illinois Quality-Adjusted Life Years Medical emergency business |
| Zdroj: | Value in Health. 24:522-529 |
| ISSN: | 1098-3015 |
| DOI: | 10.1016/j.jval.2020.10.008 |
| Popis: | Objectives Uncontrolled hypertension is a common cause of cardiovascular disease, which is the deadliest and costliest chronic disease in the United States. Pharmacists are an accessible community healthcare resource and are equipped with clinical skills to improve the management of hypertension through medication therapy management (MTM). Nevertheless, current reimbursement models do not incentivize pharmacists to provide clinical services. We aim to investigate the cost-effectiveness of a pharmacist-led comprehensive MTM clinic compared with no clinic for 10-year primary prevention of stroke and cardiovascular disease events in patients with hypertension. Methods We built a semi-Markov model to evaluate the clinical and economic consequences of an MTM clinic compared with no MTM clinic, from the payer perspective. The model was populated with data from a recently published controlled observational study investigating the effectiveness of an MTM clinic. Methodology was guided using recommendations from the Second Panel on Cost-Effectiveness in Health and Medicine, including appropriate sensitivity analyses. Results Compared with no MTM clinic, the MTM clinic was cost-effective with an incremental cost-effectiveness ratio of $38 798 per quality-adjusted life year (QALY) gained. The incremental net monetary benefit was $993 294 considering a willingness-to-pay threshold of $100 000 per QALY. Health-benefit benchmarks at $100 000 per QALY and $150 000 per QALY translate to a 95% and 170% increase from current reimbursement rates for MTM services. Conclusions Our model shows current reimbursement rates for pharmacist-led MTM services may undervalue the benefit realized by US payers. New reimbursement models are needed to allow pharmacists to offer cost-effective clinical services. |
| Databáze: | OpenAIRE |
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