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

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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 (2020) Impact of a clinical pharmacist intervention on medicine costs in patients with chronic obstructive pulmonary disease in India. PharmacoEconomics - Open, 4. pp. 331-342. ISSN 2509-4254 (https://doi.org/10.1007/s41669-019-0172-x)

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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.

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