Impact of a Clinical Pharmacist Intervention on Medicine Costs in Patients with Chronic Obstructive Pulmonary Disease in India.
Journal
PharmacoEconomics - open
ISSN: 2509-4254
Titre abrégé: Pharmacoecon Open
Pays: Switzerland
ID NLM: 101700780
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
pubmed:
2
8
2019
medline:
2
8
2019
entrez:
2
8
2019
Statut:
ppublish
Résumé
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality, especially in low- and middle-income countries (LMICs) such as India. Medicine costs are a key issue in LMICs, with typically high patient co-payments. In addition, pharmacists are underutilised in LMICs, including India. However, pharmacist-led educational interventions may improve the care of patients with COPD, as well as reduce medicine costs. Consequently, the objective of this study was to assess the effectiveness of a pharmacist-led intervention in reducing medicine costs. We assessed the impact of a pharmacist intervention on direct medicine costs in COPD patients (medicine costs and pharmacist time) in a randomised controlled study involving an intervention and control group, conducted at a tertiary care teaching hospital in India. The 6-monthly cost of medicines at baseline increased with disease severity, from a maximum of US$29.46 for those with mild COPD to US$63.28 for those with very severe COPD. Substantial savings in medical costs were achieved with the pharmacist-led programme, to a maximum of US$20.49 over 6 months for very severe patients. This equates to a reduction of 30.6% in medicine costs (p < 0.001), reduced to 26.1% when pharmacists' time (US$3.00/patient) was included. There could be a key role for pharmacists as educators for COPD patients in LMICs, to improve care and reduce costs, including patient co-payments.
Sections du résumé
BACKGROUND
BACKGROUND
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality, especially in low- and middle-income countries (LMICs) such as India. Medicine costs are a key issue in LMICs, with typically high patient co-payments. In addition, pharmacists are underutilised in LMICs, including India. However, pharmacist-led educational interventions may improve the care of patients with COPD, as well as reduce medicine costs. Consequently, the objective of this study was to assess the effectiveness of a pharmacist-led intervention in reducing medicine costs.
METHODOLOGY
METHODS
We assessed the impact of a pharmacist intervention on direct medicine costs in COPD patients (medicine costs and pharmacist time) in a randomised controlled study involving an intervention and control group, conducted at a tertiary care teaching hospital in India.
RESULTS
RESULTS
The 6-monthly cost of medicines at baseline increased with disease severity, from a maximum of US$29.46 for those with mild COPD to US$63.28 for those with very severe COPD. Substantial savings in medical costs were achieved with the pharmacist-led programme, to a maximum of US$20.49 over 6 months for very severe patients. This equates to a reduction of 30.6% in medicine costs (p < 0.001), reduced to 26.1% when pharmacists' time (US$3.00/patient) was included.
CONCLUSION
CONCLUSIONS
There could be a key role for pharmacists as educators for COPD patients in LMICs, to improve care and reduce costs, including patient co-payments.
Identifiants
pubmed: 31368087
doi: 10.1007/s41669-019-0172-x
pii: 10.1007/s41669-019-0172-x
pmc: PMC7248138
doi:
Types de publication
Journal Article
Langues
eng
Pagination
331-342Références
Thorax. 2009 Nov;64(11):939-43
pubmed: 19703830
Int J Pharm Pract. 2015 Feb;23(1):36-43
pubmed: 25409898
Indian J Occup Environ Med. 2018 Jan-Apr;22(1):40-44
pubmed: 29743784
Int J Chron Obstruct Pulmon Dis. 2018 Feb 26;13:695-702
pubmed: 29520137
J Allergy Clin Immunol. 2006 Oct;118(4):899-904
pubmed: 17030244
Respir Med. 2011 Jan;105(1):57-66
pubmed: 20932736
Int J Chron Obstruct Pulmon Dis. 2014 Feb 27;9:277-86
pubmed: 24600220
Thorax. 2004 Mar;59(3):199-203
pubmed: 14985552
NPJ Prim Care Respir Med. 2017 Apr 3;27(1):22
pubmed: 28373682
Eur Respir J. 1999 May;13(5):1109-14
pubmed: 10414412
Front Pharmacol. 2018 May 29;9:442
pubmed: 29896100
Curr Opin Pulm Med. 2017 Mar;23(2):139-148
pubmed: 27898452
Clin Ther. 2000 Apr;22(4):452-69
pubmed: 10823366
Int J Chron Obstruct Pulmon Dis. 2016 Oct 05;11:2497-2507
pubmed: 27785006
Respir Med. 2008 Jan;102(1):92-101
pubmed: 17881206
Clinicoecon Outcomes Res. 2015 Mar 16;7:153-9
pubmed: 25834458
Singapore Med J. 2019 Jan;60(1):31-33
pubmed: 29774362
Int J Chron Obstruct Pulmon Dis. 2008;3(4):701-12
pubmed: 19281084
Int J Chron Obstruct Pulmon Dis. 2016 Oct 19;11:2625-2632
pubmed: 27799761
Tuberc Respir Dis (Seoul). 2019 Jan;82(1):27-34
pubmed: 30302958
Int J Tuberc Lung Dis. 2012 Sep;16(9):1270-7
pubmed: 22871327
Swiss Med Wkly. 2017 Dec 12;147:w14567
pubmed: 29231234
Basic Clin Pharmacol Toxicol. 2011 Apr;108(4):224-33
pubmed: 21414143
Int J Qual Health Care. 2019 Jun 1;31(5):338-345
pubmed: 30169688
Br J Clin Pharmacol. 2009 Oct;68(4):588-98
pubmed: 19843062
Chest. 2000 Nov;118(5):1278-85
pubmed: 11083675
Respir Med. 2016 Feb;111:39-46
pubmed: 26725462
J Family Med Prim Care. 2015 Apr-Jun;4(2):159-61
pubmed: 25949958
Nicotine Tob Res. 2010 Mar;12(3):217-25
pubmed: 20100808
Value Health. 2012 Jul-Aug;15(5):664-73
pubmed: 22867775
Indian J Public Health. 2018 Jul-Sep;62(3):167-170
pubmed: 30232963
Int J Clin Pract. 2015 Mar;69(3):336-49
pubmed: 25363328
J Am Pharm Assoc (2003). 2011 Mar-Apr;51(2):203-11
pubmed: 21382811
Lancet Glob Health. 2018 Dec;6(12):e1363-e1374
pubmed: 30219316
Lancet. 2009 Jan 17;373(9659):240-9
pubmed: 19042012
Int J Clin Pharm. 2012 Feb;34(1):53-62
pubmed: 22101426
Int J Chron Obstruct Pulmon Dis. 2014 Jun 06;9:597-611
pubmed: 24944511
J Clin Pharm Ther. 2016 Feb;41(1):78-83
pubmed: 26775599
BMJ Open. 2017 May 29;7(5):e015211
pubmed: 28554925
Curr Med Res Opin. 2010 Oct;26(10):2421-9
pubmed: 20815661
Chest. 2016 Aug;150(2):394-406
pubmed: 27060726
Integr Pharm Res Pract. 2017 Feb 07;6:53-59
pubmed: 29354551
Thorax. 2008 Sep;63(9):831-8
pubmed: 18728206
Chest. 2015 Jul;148(1):138-150
pubmed: 25675282
Respir Med. 2003 Mar;97 Suppl C:S71-9
pubmed: 12647945
Res Social Adm Pharm. 2017 Jul - Aug;13(4):885-886
pubmed: 28222951
Cochrane Database Syst Rev. 2013 Oct 10;(10):CD009437
pubmed: 24108523
Front Pharmacol. 2017 Nov 09;8:751
pubmed: 29163151
Arch Intern Med. 2003 Mar 10;163(5):585-91
pubmed: 12622605
BMC Health Serv Res. 2016 Jul 12;16:251
pubmed: 27406133
Res Social Adm Pharm. 2018 Apr;14(4):402-403
pubmed: 29329994
Pharmacy (Basel). 2016 Oct 28;4(4):
pubmed: 28970408
Am J Respir Crit Care Med. 2017 May 15;195(10):1333-1343
pubmed: 27409253
Indian J Med Ethics. 2011 Oct-Dec;8(4):261
pubmed: 22106675
Respir Med. 2008 Apr;102(4):593-604
pubmed: 18083019
Res Social Adm Pharm. 2018 Oct;14(10):909-914
pubmed: 29104008
Prim Care Respir J. 2012 Sep;21(3):249-51
pubmed: 22885564
Aging Male. 2020 Dec;23(5):396-402
pubmed: 30269623
Respirology. 2016 Jan;21(1):14-23
pubmed: 26494423
Respir Med. 2003 Mar;97 Suppl C:S81-9
pubmed: 12647946
Clinicoecon Outcomes Res. 2017 Feb 10;9:127-137
pubmed: 28228660
Can Respir J. 2007 Jan-Feb;14(1):25-9
pubmed: 17315055
Eur Respir J. 2006 Feb;27(2):397-412
pubmed: 16452599
Am J Respir Crit Care Med. 1999 Dec;160(6):2000-5
pubmed: 10588620
COPD. 2014 Aug;11(4):431-7
pubmed: 24568315
Patient Educ Couns. 2004 Mar;52(3):259-66
pubmed: 14998595