Budget Impact Analysis of Pharmacist-Led Medication Management in Cardiovascular and Type 2 Diabetic Patients

Area of Science:

• Health Economics
• Clinical Pharmacy
• Public Health

Background:

• Polypharmacy is common in patients with hypertension, cardiovascular disease (CVD), and/or type 2 diabetes mellitus (DMT2).
• Medication mismanagement and irrational drug use contribute to adverse clinical events and increased healthcare costs.
• Comprehensive Medication Management (CMM) services aim to optimize medication therapy and improve patient outcomes.

Purpose of the Study:

• To identify and measure the costs and savings associated with delivering CMM services in Croatia.
• To evaluate the budget impact of CMM for patients with hypertension and at least one additional CVD and/or DMT2, using five or more medications daily.
• To determine the affordability of CMM as an intervention for medication mismanagement.

Main Methods:

• A budget impact analysis (BIA) was conducted, comparing total CMM costs with expected cost reductions.
• Cost reductions were estimated based on reduced incidence of adverse clinical events and healthcare service utilization.
• Data on medication costs, labor, and training were sourced from a pilot CMM intervention in Zagreb, supplemented by international literature.

Main Results:

• Total 3-year costs for CMM services amounted to EUR 7,849,962 (EUR 57 per patient per year).
• Expected 3-year healthcare cost reductions due to CMM were EUR 7,787,765.
• The net 3-year budget impact of CMM was EUR 92,869 (EUR 0.67 incremental cost per patient).

Conclusions:

• CMM services represent an affordable intervention in the Croatian healthcare system.
• CMM effectively addresses medication mismanagement and irrational drug use in complex patient populations.
• The findings support the wider implementation of CMM services to improve patient care and reduce healthcare expenditures.