OBJECTIVES: This analysis asesses the cost-effectiveness of interventions conducted by community pharmacists in Japan that modify the lifestyle of patients with type 2 diabetes mellitus (T2DM).

METHODS: We conducted the Community Pharmacists Assists (COMPASS) Project, a cluster randomized controlled trial in Japan. In the project, community pharmacists support these patients’ lifestyle modification within three minutes. The result indicated that brief intervention conducted by community pharmacists could significantly decrease HbA1c in patients with T2DM. Using the Markov model, we estimated the effect of the intervention conducted in the COMPASS Project on the medical cost of diabetic retinopathy in the future. We conducted the analysis from payer's perspective. A 10-year model with annual cycle duration was developed. Progression of diabetic retinopathy was characterized into three degrees. Incremental cost effectiveness ratios (ICER) were expressed in JPY per quality-adjusted life year (QALY) gained with costs discounted at 3% over 10 years. We conducted deterministic sensitivity analysis to assess the effect of uncertainly on the model.

RESULTS: In the survey periods, medical cost was calculated at 2,227,817 JPY for the intervention group, while it was 2,251,375 JPY for the control group.These interventions conducted in the COMPASS Project were shown to be cost-effective with an ICER of -2,441,196.11 JPY/QALY gained. Sensitivity analysis did not change the results.

CONCLUSIONS: This analysis suggests that the intervention conducted in the COMPASS Project was cost-effective for diabetic retinopathy. Hence, community pharmacists should actively support patients with diabetes.