Diabetes Screening Through Community Pharmacies in England: A Cost-Effectiveness Study

Area of Science:

• Public Health
• Health Economics
• Pharmacy Practice

Background:

• Community pharmacies are pivotal in public health, frequently utilized for screening chronic conditions like diabetes.
• Estimating the economic impact and efficiency of these screening services is crucial for resource allocation and service improvement.

Purpose of the Study:

• To determine the cost per test and cost per appropriately referred patient for diabetes screening conducted in community pharmacies.
• To analyze the influence of geographical location and patient referral rates on the cost-effectiveness of pharmacy-based diabetes screening.

Main Methods:

• A one-year decision tree model was employed to estimate costs from a pharmacy perspective.
• One-way sensitivity analysis was conducted to assess the impact of varying geographical locations and patient self-referral rates.
• Data were collected from 164 patients in an average deprivation area and 172 patients in a high deprivation area in England, involving risk assessment questionnaires and HbA1c testing.

Main Results:

• The estimated cost per person screened was £28.65.
• The cost per appropriately referred patient with type 2 diabetes ranged from £7,638 (deprived, mixed ethnicity) to £11,297 (non-deprived).
• Costs increased significantly (to £12,730–£18,828) if only 60% of referred patients informed their general practitioner (GP), highlighting the importance of adherence.

Conclusions:

• Community pharmacy diabetes screening demonstrates comparable cost-effectiveness to medical practices.
• Optimizing cost-effectiveness involves strategic placement of services in high-prevalence areas and enhancing patient follow-through to GP appointments.
• Improving patient adherence to pharmacist recommendations is key to maximizing the value of community-based diabetes screening programs.