Cost-Utility of Pharmacist-Led Deprescribing Interventions for Community-Dwelling Older Adults: A Systematic Review

Inappropriate medications continue to be dispensed to older adults. Deprescribing is an intervention carried out under the supervision of a health care professional, where medications that may cause harm or are no longer beneficial are reduced or withdrawn. Pharmacists play a crucial role in deprescribing potentially inappropriate medications. This systematic review aimed to summarize available evidence regarding the costs and cost-utility of pharmacist-led (or involved) deprescribing interventions for community-dwelling older adults.

A systematic literature search was conducted from inception to June 6, 2025, using MEDLINE, EMBASE, CINAHL, and Cochrane Central. The titles and abstracts were screened, followed by eligibility assessment of full texts. The quality of studies was appraised using the Quality of Health Economic Studies (QHES) and Consolidated Health Economic Evaluation Reporting Standards (CHEERS) checklists. The cost-utility results were synthesized narratively.

The search strategies identified a total of 3948 records, of which 9 articles were ultimately included in the systematic review based on inclusion and exclusion criteria. All economic evaluations were performed with a time horizon ranging from 6 to 12 months, and in most studies, the outcomes were derived from a single clinical trial. The cost-utility analyses varied, with some strategies being dominant to an incremental cost-utility ratio of €86 360.00 per quality-adjusted life-year.

The cost-utility analyses indicated that pharmacist-led deprescribing interventions are generally a cost-effective option compared with usual care. While these interventions appear promising from an economic standpoint, more long-term, population-based studies are needed to validate these findings.