A Cost Analysis and Cost-Utility Analysis of a Community Pharmacist–Led Intervention on Reducing Cardiovascular Risk: The Alberta Vascular Risk Reduction Community Pharmacy Project (RxEACH)

Oct 1, 2019, 00:00
10.1016/j.jval.2019.05.012
https://www.valueinhealthjournal.com/article/S1098-3015(19)32235-1/fulltext
Title : A Cost Analysis and Cost-Utility Analysis of a Community Pharmacist–Led Intervention on Reducing Cardiovascular Risk: The Alberta Vascular Risk Reduction Community Pharmacy Project (RxEACH)
Citation : https://www.valueinhealthjournal.com/action/showCitFormats?pii=S1098-3015(19)32235-1&doi=10.1016/j.jval.2019.05.012
First page : 1128
Section Title : ECONOMIC EVALUATION
Open access? : No
Section Order : 1128

Background

A randomized trial (the Alberta Vascular Risk Reduction Community Pharmacy Project) showed that a community pharmacist-led intervention was efficacious for reducing cardiovascular (CV) risk. However, the cost of this strategy is unknown.

Objectives

We examined the short- and long-term cost of a pharmacist-led intervention to reduce CV risk compared to usual care.

Methods

We conducted a trial-based cost analysis from the perspective of a publicly funded healthcare system. Over 3 and 12 months of follow-up, we examined specific intervention costs (pharmacy claims), related intervention costs (laboratory tests and medications), and ongoing healthcare costs (physician claims, emergency department visits, and hospital admissions). We also used the validated CV Disease Policy Model–Canada to estimate the long-term effects.

Results

A total of 684 participants (mean age 62, 57% male) were included. Overall, there were no significant differences in healthcare costs at 3 or 12 months between the usual care and intervention groups (P = .127). The CV disease-related healthcare cost of managing a patient over a lifetime was estimated to be Can$45 530 (95% uncertainty interval [UI], 45 460-45 580) and Can$40 750 (95% UI, 37 780-43 620) in usual care and intervention groups, respectively, an incremental cost savings of Can$4770 per patient (95% UI, 1900-7760). The intervention dominated usual care (better outcomes and lower costs) across 3-year, 5-year, 10-year, and lifetime horizons.

Conclusion

This economic analysis suggests that a clinical pathway-driven pharmacist-led intervention (previously shown to reduce CV risk) was associated with similar measured healthcare costs over 1 year, and lower extrapolated healthcare costs over a patient lifetime. This strategy could be broadly implemented to realize its benefits.

Categories :
  • Cardiovascular Disorders
  • Cost-comparison, Effectiveness, Utility, Benefit Analysis
  • Economic Evaluation
  • Health Service Delivery & Process of Care
  • Pharmacist Interventions and Practices
  • Specific Diseases & Conditions
Tags :
  • cardiovascular disease
  • cost analysis
  • economic evaluation
  • pharmacy
Regions :
  • North America
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