ECONOMIC EVALUATION OF MULTICOMPONENT COMMUNICATION TRAINING FOR DEPRESCRIBING CARDIOMETABOLIC MEDICATION IN DUTCH OLDER ADULTS :THE CO-DEPRESCRIBE TRIAL
Author(s)
ZHUOLIN ZHANG, MSc1, Peter Stuijt, Msc2, Jesse Tuinhof, Msc1, Mette Heringa, PhD3, Martina Teichert, PhD4, Jako Burgers, PhD5, Katja Taxis, PhD1, Petra Denig, PhD2, Talitha Feenstra, PhD1.
1PharmacoTherapy, - Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, Netherlands, 2Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands, 3SIR Institute for Pharmacy Practice and Policy, Leiden, Netherlands, 4Department of Research and Development, Royal Dutch Pharmacists Association, The Hague, Netherlands, 5Dutch College of General Practitioners, Utrecht, Netherlands.
1PharmacoTherapy, - Epidemiology and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, Netherlands, 2Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands, 3SIR Institute for Pharmacy Practice and Policy, Leiden, Netherlands, 4Department of Research and Development, Royal Dutch Pharmacists Association, The Hague, Netherlands, 5Dutch College of General Practitioners, Utrecht, Netherlands.
OBJECTIVES: To reduce inappropriate polypharmacy and mitigate drug-related problems, deprescribing of cardiometabolic medication is recommended in older patients when potential harms outweigh potential benefits. To support implementation of deprescribing during clinical medication reviews (CMRs) in Dutch primary care, an intervention, CO-DEPRESCRIBE, was developed. This study evaluated the short-term cost-effectiveness of the intervention compared to usual care CMRs (CAU).
METHODS: Healthcare providers (HCPs) were randomized to either the CO-DEPRESCRIBE training program or a CAU group. HCPs provided CMR to adults aged ≥75 years with polypharmacy receiving stable cardiometabolic medications. The Medical Consumption Questionnaire and the EQ-5D-5L were used to measure resource use and health-related quality of life (HRQoL), respectively, at baseline and 6 months after the CMR. Outcomes were the proportion of patients with deintensification (at least one cardiometabolic medication dose reduced or discontinued), and Quality-Adjusted Life Years (QALYs). The study was conducted from a societal perspective using 2024 price level. Multiple imputation and bootstrapping were applied. Analyses were performed using R version 4.4.1.
RESULTS: The intention-to-treat analysis included 154 patients in the intervention group and 133 in the control group. The intervention group showed more frequent deintensification (39.0% vs.24.1%), and higher costs (€543), including intervention-related costs of €140 per patient. Negligible differences in HRQoL were found, with QALYs of 0.37 in both arms. The probability of CO-DEPRESCRIBE being cost-effective was 25% at a threshold of €50,000 per QALY gained. The additional cost per additional patient achieving deintensification was €3,644.
CONCLUSIONS: The intervention led to more cardiometabolic medication deintensification but showed a low probability of being cost-effective over a 6-month time horizon compared to CAU. A lifetime horizon analysis could provide further insights.
METHODS: Healthcare providers (HCPs) were randomized to either the CO-DEPRESCRIBE training program or a CAU group. HCPs provided CMR to adults aged ≥75 years with polypharmacy receiving stable cardiometabolic medications. The Medical Consumption Questionnaire and the EQ-5D-5L were used to measure resource use and health-related quality of life (HRQoL), respectively, at baseline and 6 months after the CMR. Outcomes were the proportion of patients with deintensification (at least one cardiometabolic medication dose reduced or discontinued), and Quality-Adjusted Life Years (QALYs). The study was conducted from a societal perspective using 2024 price level. Multiple imputation and bootstrapping were applied. Analyses were performed using R version 4.4.1.
RESULTS: The intention-to-treat analysis included 154 patients in the intervention group and 133 in the control group. The intervention group showed more frequent deintensification (39.0% vs.24.1%), and higher costs (€543), including intervention-related costs of €140 per patient. Negligible differences in HRQoL were found, with QALYs of 0.37 in both arms. The probability of CO-DEPRESCRIBE being cost-effective was 25% at a threshold of €50,000 per QALY gained. The additional cost per additional patient achieving deintensification was €3,644.
CONCLUSIONS: The intervention led to more cardiometabolic medication deintensification but showed a low probability of being cost-effective over a 6-month time horizon compared to CAU. A lifetime horizon analysis could provide further insights.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE37
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Patient-Centered Research
Topic Subcategory
Trial-Based Economic Evaluation
Disease
Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity), Geriatrics