Cost-utility analysis of medication review with follow-up for cardiovascular outcomes: A microsimulation model
| Autor: | Victoria Garcia-Cardenas, José Cristian Plaza-Plaza, C. Vargas, Antonio Ahumada-Canale, Francisco Martinez-Mardones, Shalom I. Benrimoj |
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| Rok vydání: | 2021 |
| Předmět: |
Cost–utility analysis
medicine.medical_specialty business.industry Cost effectiveness Cost-Benefit Analysis Medication Review Health Policy Pharmacist Pharmacy Time horizon Pharmacists Disease cluster law.invention Randomized controlled trial law Emergency medicine Health Policy & Services Humans 1117 Public Health and Health Services 1605 Policy and Administration Medicine Quality-Adjusted Life Years business health care economics and organizations Follow-Up Studies Cause of death |
| Zdroj: | Health Policy. 125:1406-1414 |
| ISSN: | 0168-8510 |
| DOI: | 10.1016/j.healthpol.2021.09.004 |
| Popis: | Background Cardiovascular diseases are the leading cause of death. Pharmacist-led medication review with follow-up might be cost-effective preventing cardiovascular diseases. Objective To undertake a cost–utility analysis of the addition of pharmacist-led medication review with follow-up to usual care compared to usual care alone for cardiovascular outpatients. Materials and methods A state-transition microsimulation model was built to project outcomes over a lifetime time horizon. Inputs from a cluster randomized controlled trial conducted in primary health care centers in Chile with full-time pharmacists were used. Probabilities were estimated using patient-level data. Utilities and costs associated with each health state were obtained from the literature, whereas the intervention costs were retrieved from the trial. The public third-party payer perspective was used. Uncertainty was evaluated through one-way and probabilistic sensitivity analyses. Results For the base case analysis, an incremental cost-effectiveness ratio of $963 per quality-adjusted life-year was observed which was considered cost-effective. The results were robust to sensitivity analyses and were driven by decreased cardiovascular events resulting in lower mortality. Conclusions Medication review with follow-up was deemed a cost-effective addition to usual care with low uncertainty. |
| Databáze: | OpenAIRE |
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