Cost-effectiveness of shared pharmaceutical care for older patients: RESPECT trial findings
| Autor: | Mark Sculpher, Jeremy N. V. Miles, Stewart Richmond, Ben Cross, Andrea Hilton, Ian J. Russell, H Chrystyn, Zoë Philips, I Chi Kei Wong, Amanda Farrin, G Hill, Respect Trial Team, Veronica Morton, Chris Bojke, Peter Campion, Simon Coulton |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Prescription Drugs Health Services for the Aged Cost effectiveness Cost-Benefit Analysis Community Pharmacy Services Original Paper - Full-length version Patient Care Planning law.invention Quality of life (healthcare) Drug Therapy Randomized controlled trial law Medication therapy management medicine Humans health care economics and organizations Aged Aged 80 and over Geriatrics business.industry United Kingdom Quality-adjusted life year Pharmaceutical care Family medicine Economic evaluation Female Quality-Adjusted Life Years Family Practice business |
| Zdroj: | British Journal of General Practice. 60:e20-e27 |
| ISSN: | 1478-5242 0960-1643 |
| DOI: | 10.3399/bjgp09x482312 |
| Popis: | Background Pharmaceutical care serves as a collaborative model for medication review. Its use is advocated for older patients, although its cost-effectiveness is unknown. Although the accompanying article on clinical effectiveness from the RESPECT (Randomised Evaluation of Shared Prescribing for Elderly people in the Community over Time) trial finds no statistically significant impact on prescribing for older patients undergoing pharmaceutical care, economic evaluations are based on an estimation, rather than hypothesis testing. Aim To evaluate the cost-effectiveness of pharmaceutical care for older people compared with usual care, according to National Institute for Health and Clinical Excellence (NICE) reference case standards. Methods An economic evaluation was undertaken in which NICE reference case standards were applied to data collected in the RESPECT trial. Results On average, pharmaceutical care is estimated to cost an incremental £10 000 per additional quality-adjusted life year (QALY). If the NHS9s cost-effectiveness threshold is between £20 000 and £30 000 per extra QALY, then the results indicate that pharmaceutical care is cost-effective despite a lack of statistical significance to this effect. However, the statistical uncertainty surrounding the estimates implies that the probability that pharmaceutical care is not cost-effective lies between 0.22 and 0.19. Although results are not sensitive to assumptions about costs, they differ between subgroups: in patients aged >75 years pharmaceutical care appears more cost-effective for those who are younger or on fewer repeat medications. Conclusion Although pharmaceutical care is estimated to be cost-effective in the UK, the results are uncertain and further research into its long-term benefits may be worthwhile. |
| Databáze: | OpenAIRE |
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