OBJECTIVES: Medication errors that lead to adverse drug effects are an important source of unintentional patient harm and economic burden. A decreased kidney function is one of the risk factors for (preventable) drug-related hospital admissions. The incidence of renal impairment is increasing, thus medication monitoring will become more important. However, within public pharmacies, there is large number of unknown or outdated kidney function values, that can lead to an overload of signals from medication monitoring, which leads to alert fatigue. To reduce this problem, Point-of-Care tests can be introduced in public pharmacies. The objective of this study was to estimate the cost-effectiveness of a PoCT creatinine meter for renal function measurement in community pharmacies in the Netherlands, to prevent antibiotic-related hospitalizations.

METHODS: The introduction of the PoCT was compared with the standard of care in public pharmacies according to antibiotic prescriptions in case of impaired kidney functions. A decision tree was used to assess the process of an antibiotic prescription in public pharmacies and the possible consequences, based on real-life patient data. Direct costs of renal function screening, antibiotic treatments and medical care due to antibiotic-related hospitalization were included. For completeness, univariate and probabilistic sensitivity analysis were performed.

RESULTS: The intervention is deemed cost-saving and provides health gains, with the probability of being cost-effective of 81.1% for every threshold willingness to pay. The budget-impact analysis shows that the introduction of the PoCT in community pharmacies will save €95.38/patient each year.

CONCLUSIONS: The results indicate that the introduction of the PoCT in public pharmacies in the Netherlands is cost-saving. In addition, we estimate a positive budget impact due to anticipated cost-savings per patient.