OBJECTIVES: This analysis evaluates the cost-effectiveness of interventions performed by community pharmacists to support lifestyle modification in patients with type II diabetes.

METHODS: In 2011, we conducted the Community Pharmacists Assists (COMPASS) project to investigate the effect of support offered by community pharmacists’ for improving lifestyle habits in patients with type II diabetes in japan. The COMPASS project was a randomized controlled trial with pharmacies as clusters, and the pharmacists in the intervention group provided support to improve lifestyle habits within 3 min in patients with type II diabetes for 6 months. HbA1c significantly decreased in the intervention group when compared with the control group. In this study, we focused on diabetic foot ulcer, one of the three major complications of diabetes, and evaluated the cost-effectiveness of pharmacists’ interventions performed in this project using Markov model. The model estimated the payer’s perspective for a 20-year period. The degree of progression of diabetic foot ulcer classified as follows: "no neuropathy," "neuropathy," "first lower extremity amputation," "second lower extremity amputation," "death". Estimated cost (JPY), quality-adjusted life year (QALY) by simulating the transition of state stage (a discount rate of 3% was used for cost estimation), and cost-effectiveness ratio (CER) were calculated.

RESULTS: The cost in the intervention group was lower than that in the control group (¥1,705,787 vs. ¥1,963,491). QALY gained by the intervention group was higher than that by the control group (13.64 vs. CONCLUSIONS: This analysis showed that pharmacist intervention in the COMPASS project was cost-effective. Therefore, pharmacists should actively support diabetic patients for modifying their lifestyle habit.