Improving adherence to lipid-lowering therapy in a community pharmacy intervention program: a cost-effectiveness
Stefan Vegter1, Piter Oosterhof, Job F M van Boven
1University of Groningen, 9713 AV, Groningen, Netherlands. s.vegter@rug.nl.
Journal of Managed Care & Specialty Pharmacy
|June 27, 2014
Summary
Community pharmacy pharmaceutical care improves adherence to lipid-lowering therapy, leading to significant cardiovascular event reduction and cost savings. This intervention offers good value for money and warrants reimbursement consideration.
Area of Science:
- Pharmacoeconomics
- Public Health
- Cardiovascular Disease Prevention
Background:
- Community pharmacy pharmaceutical care enhances chronic therapy adherence.
- Long-term clinical outcomes and cost-effectiveness of such programs require further study.
Purpose of the Study:
- To assess the cost-effectiveness of the MeMO pharmaceutical care intervention program in Dutch community pharmacies.
- To evaluate the program's impact on adherence to lipid-lowering therapy.
Main Methods:
- Economic evaluation using a time-dependent Markov model from a healthcare payer perspective.
- Intervention: MeMO program (Medication Monitoring and Optimisation) in 9 Dutch community pharmacies for new lipid-lowering therapy patients.
- Outcomes: Modeled lifelong costs, quality of life, cardiovascular event reductions, and cost-effectiveness ratios based on therapy discontinuation rates.
Main Results:
- The MeMO program significantly reduced therapy discontinuation (RR=0.49).
- A cohort of 1,000 patients experienced reduced cardiovascular events (strokes, MIs) and revascularizations.
- The program yielded net cost savings of €32,000 and gained 84 quality-adjusted life-years (QALYs).
Conclusions:
- Pharmaceutical care in community pharmacies improves statin adherence and prevents cardiovascular events.
- The MeMO program demonstrates significant clinical benefits and cost savings, offering good value.
- Health care insurers should consider reimbursement for community pharmacy adherence programs.
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