Impact of a clinical pharmacist intervention on medicine costs in patients with chronic obstructive pulmonary disease in India

Abdulsalim, Suhaj and Kesavan, Unnikrishnan Mazhuvancherry and Mohan, Manu K. and Alsahali, Saud and Alrasheedy, Alian A. and Martin, Antony P and Godman, Brian and Alfadl, Abubakr A (2019) Impact of a clinical pharmacist intervention on medicine costs in patients with chronic obstructive pulmonary disease in India. PharmacoEconomics - Open. ISSN 2509-4254

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    Abstract

    Background: Chronic Obstructive Pulmonary Disease (COPD) is a major cause of morbidity and mortality especially in lower and middle income countries (LMICs) such as India. Medicine costs are a key issue in LMICs with typically high patient co-payments. In addition, pharmacists are underutilised in LMICs including India. However, pharmacist-led educational interventions may improve the care of patients with COPD as well as reduce medicine costs. Consequently, the objective of this study was to assess the effectiveness of a pharmacist led intervention in reducing medicine costs. Methodology: We assessed the impact of a pharmacist intervention on direct medicine costs in COPD patients (medicine costs and pharmacist time) in a randomized controlled study involving an intervention and control group and conducted at a tertiary care teaching hospital in India. Results: The six-monthly cost of medicines at baseline increased with disease severity from a maximum of US$29.46 for those with mild COPD up to US$63.28 for those with very severe COPD. Substantial savings in medical costs were achieved with the pharmacist-led programme, up to a maximum of US$20.49 over six-months for very severe patients. This equates to a reduction of 30.6% in medicine costs (P < 0.001), reduced to 26.1% when pharmacists’ time (US$3.00/ patient) is included. Conclusion: There could be a key role for pharmacists as educators in COPD patients in LMICs to improve care and reduce costs including patient co-payments.