COST-BENEFIT ANALYSIS OF PHARMACIST-LED VIDEO TELEHEALTH MEDICATION THERAPY MANAGEMENT IN ADOLESCENTS AND YOUNG ADULTS WITH ASTHMA: A RANDOMIZED CONTROLLED TRIAL
Author(s)
Suk-Chan Jang, PharmD, PhD1, Shao-Hsuan Chang, BS, MS1, Kathryn Blake, PharmD2, Lin Nan, MD, ScM3, Tracy Leonard, RPh1, Janet Holbrook, PhD, MPH3, Elizabeth Sugar, PhD3, Heather Hazucha, MPH3, Gary Guan, PharmD1, Robert Wise, MD3, Haesuk Park, PhD1;
1University of Florida, Gainesville, FL, USA, 2Nemours Children's Health, Jacksonville, FL, USA, 3Johns Hopkins University, Baltimore, MD, USA
1University of Florida, Gainesville, FL, USA, 2Nemours Children's Health, Jacksonville, FL, USA, 3Johns Hopkins University, Baltimore, MD, USA
OBJECTIVES: In adolescents and young adults with asthma, inhaled corticosteroid adherence is low, and inhaler technique is often poor. We evaluated the cost-benefit of pharmacist‑led video telehealth medication therapy management integrated with digital adherence monitoring (MTM‑DAM) versus digital adherence monitoring (DAM) alone.
METHODS: In the two-arm, multisite randomized controlled trial (MATCH), participants aged 12-35 years with poorly controlled asthma from 23 clinics were randomized to MTM‑DAM or DAM. The primary outcome was asthma exacerbation, defined as ≥3 days of oral corticosteroids, emergency department visit with systemic corticosteroids, or hospitalization (any cause) during a mean follow-up of 11 months. Costs and benefits were monetized to estimate per‑patient per-year (PPPY) costs of MTM‑DAM relative to DAM. Costs included MTM service delivery, asthma medications, healthcare utilization related to asthma exacerbations, and productivity losses. Cost-benefit analyses were conducted from healthcare payer and societal perspectives, with all costs adjusted to 2025 US dollars.
RESULTS: This analysis included 295 participants (mean [SD] age 22.3 [7.5] years; 65% female; 26% Black), with 157 in the MTM‑DAM group and 138 in the DAM group. PPPY MTM service costs were $539 in the MTM-DAM group versus $0 in the DAM group. PPPY costs for asthma medications ($5,512 vs $7,468), asthma exacerbations ($524 vs $1,118), and productivity losses ($8,135 vs $8,714) were lower in the MTM‑DAM group compared to the DAM group. These differences resulted in PPPY net savings of $ 2,011 (healthcare payer perspective) and $2,590 (societal perspectives). Probabilistic sensitivity analyses indicated a 90.3% probability that MTM-DAM was cost-beneficial.
CONCLUSIONS: Pharmacist‑led video MTM integrated with DAM achieved cost savings compared with DAM alone, driven by reductions in exacerbation‑related healthcare utilization, lower medication costs (including biologics), and decreased productivity losses. These findings support the adoption of MTM‑DAM to improve the value of asthma care in adolescents and young adults.
METHODS: In the two-arm, multisite randomized controlled trial (MATCH), participants aged 12-35 years with poorly controlled asthma from 23 clinics were randomized to MTM‑DAM or DAM. The primary outcome was asthma exacerbation, defined as ≥3 days of oral corticosteroids, emergency department visit with systemic corticosteroids, or hospitalization (any cause) during a mean follow-up of 11 months. Costs and benefits were monetized to estimate per‑patient per-year (PPPY) costs of MTM‑DAM relative to DAM. Costs included MTM service delivery, asthma medications, healthcare utilization related to asthma exacerbations, and productivity losses. Cost-benefit analyses were conducted from healthcare payer and societal perspectives, with all costs adjusted to 2025 US dollars.
RESULTS: This analysis included 295 participants (mean [SD] age 22.3 [7.5] years; 65% female; 26% Black), with 157 in the MTM‑DAM group and 138 in the DAM group. PPPY MTM service costs were $539 in the MTM-DAM group versus $0 in the DAM group. PPPY costs for asthma medications ($5,512 vs $7,468), asthma exacerbations ($524 vs $1,118), and productivity losses ($8,135 vs $8,714) were lower in the MTM‑DAM group compared to the DAM group. These differences resulted in PPPY net savings of $ 2,011 (healthcare payer perspective) and $2,590 (societal perspectives). Probabilistic sensitivity analyses indicated a 90.3% probability that MTM-DAM was cost-beneficial.
CONCLUSIONS: Pharmacist‑led video MTM integrated with DAM achieved cost savings compared with DAM alone, driven by reductions in exacerbation‑related healthcare utilization, lower medication costs (including biologics), and decreased productivity losses. These findings support the adoption of MTM‑DAM to improve the value of asthma care in adolescents and young adults.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE498
Topic
Economic Evaluation
Disease
SDC: Pediatrics, SDC: Respiratory-Related Disorders (Allergy, Asthma, Smoking, Other Respiratory)