Bridging the gap between expanded pharmacy services and payment models: A jurisdictional scan.

Area of Science:

• Health Services Research
• Pharmaceutical Policy
• Health Economics

Background:

• Pharmacists' roles have expanded beyond dispensing to include medication reviews, minor ailment prescribing, and vaccinations.
• The fee-for-service model in British Columbia, Canada, is a recognized barrier to service uptake.
• Understanding international remuneration models is crucial for designing effective future payment systems.

Purpose of the Study:

• To identify the structure, funding mechanisms, and provider incentives of pharmacy remuneration models for minor ailments in OECD countries.
• To assess the impacts of these models on service uptake, cost-effectiveness, healthcare access, and associated barriers/facilitators.

Main Methods:

• A PRISMA-guided literature review of MEDLINE and EMBASE databases (2003-2023).
• Searched for pharmacy services, remuneration, and minor ailments in OECD countries.
• Included 11 primary studies and 5 systematic reviews.

Main Results:

• Three payment models were identified: fee-for-service, performance-based payment models (PBPM), and capitation.
• Fee-for-service models encourage dispensing volume but offer little incentive for quality care.
• PBPM models promote quality care but may lack flexibility; capitation models have minimal supporting evidence.

Conclusions:

• Alternative payment models can encourage expanded pharmacist services, offering benefits like cost savings and improved patient care.
• Designing effective payment models requires prioritizing stakeholder engagement and addressing equity concerns.
• Further research into capitation models is warranted.