Cost-utility analysis of medication review with follow-up for cardiovascular outcomes: A microsimulation model.

Ahumada-Canale, A; Vargas, C; Martinez-Mardones, F; Plaza-Plaza, JC; Benrimoj, S; Garcia-Cardenas, V

Cost-utility analysis of medication review with follow-up for cardiovascular outcomes: A microsimulation model.

Ahumada-Canale, A Vargas, C Martinez-Mardones, F Plaza-Plaza, JC Benrimoj, S Garcia-Cardenas, V

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Publisher:: Elsevier BV
Publication Type:: Journal Article
Citation:: Health Policy, 2021
Issue Date:: 2021-09-16

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Field	Value	Language
dc.contributor.author	Ahumada-Canale, A
dc.contributor.author	Vargas, C
dc.contributor.author	Martinez-Mardones, F
dc.contributor.author	Plaza-Plaza, JC
dc.contributor.author	Benrimoj, S
dc.contributor.author	Garcia-Cardenas, V
dc.date.accessioned	2021-10-08T01:02:33Z
dc.date.available	2021-09-13
dc.date.available	2021-10-08T01:02:33Z
dc.date.issued	2021-09-16
dc.identifier.citation	Health Policy, 2021
dc.identifier.issn	0168-8510
dc.identifier.issn	1872-6054
dc.identifier.uri	http://hdl.handle.net/10453/150918
dc.description.abstract	BACKGROUND: Cardiovascular diseases are the leading cause of death. Pharmacist-led medication review with follow-up might be cost-effective preventing cardiovascular diseases. OBJECTIVE: To undertake a cost-utility analysis of the addition of pharmacist-led medication review with follow-up to usual care compared to usual care alone for cardiovascular outpatients. MATERIALS AND METHODS: A state-transition microsimulation model was built to project outcomes over a lifetime time horizon. Inputs from a cluster randomized controlled trial conducted in primary health care centers in Chile with full-time pharmacists were used. Probabilities were estimated using patient-level data. Utilities and costs associated with each health state were obtained from the literature, whereas the intervention costs were retrieved from the trial. The public third-party payer perspective was used. Uncertainty was evaluated through one-way and probabilistic sensitivity analyses. RESULTS: For the base case analysis, an incremental cost-effectiveness ratio of $963 per quality-adjusted life-year was observed which was considered cost-effective. The results were robust to sensitivity analyses and were driven by decreased cardiovascular events resulting in lower mortality. CONCLUSIONS: Medication review with follow-up was deemed a cost-effective addition to usual care with low uncertainty.
dc.language	eng
dc.publisher	Elsevier BV
dc.relation.ispartof	Health Policy
dc.relation.isbasedon	10.1016/j.healthpol.2021.09.004
dc.rights	info:eu-repo/semantics/embargoedAccess
dc.subject	1117 Public Health and Health Services, 1605 Policy and Administration
dc.subject.classification	Health Policy & Services
dc.title	Cost-utility analysis of medication review with follow-up for cardiovascular outcomes: A microsimulation model.
dc.type	Journal Article
utslib.location.activity	Ireland
utslib.for	1117 Public Health and Health Services
utslib.for	1605 Policy and Administration
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Graduate School of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Graduate School of Health/GSH.Pharmacy
utslib.copyright.status	open_access	*
utslib.copyright.embargo	2022-09-16T00:00:00+1000Z
dc.date.updated	2021-10-08T01:02:32Z
pubs.publication-status	Published online

Abstract:

BACKGROUND: Cardiovascular diseases are the leading cause of death. Pharmacist-led medication review with follow-up might be cost-effective preventing cardiovascular diseases. OBJECTIVE: To undertake a cost-utility analysis of the addition of pharmacist-led medication review with follow-up to usual care compared to usual care alone for cardiovascular outpatients. MATERIALS AND METHODS: A state-transition microsimulation model was built to project outcomes over a lifetime time horizon. Inputs from a cluster randomized controlled trial conducted in primary health care centers in Chile with full-time pharmacists were used. Probabilities were estimated using patient-level data. Utilities and costs associated with each health state were obtained from the literature, whereas the intervention costs were retrieved from the trial. The public third-party payer perspective was used. Uncertainty was evaluated through one-way and probabilistic sensitivity analyses. RESULTS: For the base case analysis, an incremental cost-effectiveness ratio of $963 per quality-adjusted life-year was observed which was considered cost-effective. The results were robust to sensitivity analyses and were driven by decreased cardiovascular events resulting in lower mortality. CONCLUSIONS: Medication review with follow-up was deemed a cost-effective addition to usual care with low uncertainty.

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http://hdl.handle.net/10453/150918