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Article: Cost-effectiveness of shared pharmaceutical care for older patients: RESPECT trial findings

TitleCost-effectiveness of shared pharmaceutical care for older patients: RESPECT trial findings
Authors
KeywordsCost-Effectiveness
Health Services For The Aged
Medication Therapy Management
Pharmaceutical Care
Issue Date2010
PublisherRoyal College of General Practitioners. The Journal's web site is located at http://www.rcgp.org.uk/webmaster/ebjgp/journallogin.asp?OrigURL=/journal/index.asp
Citation
British Journal Of General Practice, 2010, v. 60 n. 570, p. 21-27 How to Cite?
AbstractBackground: Pharmaceutical care serves as a collaborative model for medication review. Its use is advocated for older patients, although its cost-effectiveness is unknown. Although the accompanying article on clinical effectiveness from the RESPECT (Randomised Evaluation of Shared Prescribing for Elderly people in the Community over Time) trial finds no statistically significant impact on prescribing for older patients undergoing pharmaceutical care, economic evaluations are based on an estimation, rather than hypothesis testing. Aim: To evaluate the cost-effectiveness of pharmaceutical care for older people compared with usual care, according to National Institute for Health and Clinical Excellence (NICE) reference case standards. Method: An economic evaluation was undertaken in which NICE reference case standards were applied to data collected in the RESPECT trial. Results: On average, pharmaceutical care is estimated to cost an incremental £10 000 per additional quality-adjusted life year (QALY). If the NHS's cost-effectiveness threshold is between £20 000 and £30 000 per extra QALY, then the results indicate that pharmaceutical care is cost-effective despite a lack of statistical significance to this effect. However, the statistical uncertainty surrounding the estimates implies that the probability that pharmaceutical care is not cost-effective lies between 0.22 and 0.19. Although results are not sensitive to assumptions about costs, they differ between subgroups: in patients aged >75 years pharmaceutical care appears more cost-effective for those who are younger or on fewer repeat medications. Conclusion: Although pharmaceutical care is estimated to be cost-effective in the UK, the results are uncertain and further research into its long-term benefits may be worthwhile. ©British Journal of General Practice.
Persistent Identifierhttp://hdl.handle.net/10722/171394
ISSN
2015 Impact Factor: 2.741
2015 SCImago Journal Rankings: 0.767
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorBojke, Cen_US
dc.contributor.authorPhilips, Zen_US
dc.contributor.authorSculpher, Men_US
dc.contributor.authorCampion, Pen_US
dc.contributor.authorChrystyn, Hen_US
dc.contributor.authorCoulton, Sen_US
dc.contributor.authorCross, Ben_US
dc.contributor.authorMorton, Ven_US
dc.contributor.authorRichmond, Sen_US
dc.contributor.authorFarrin, Aen_US
dc.contributor.authorHill, Gen_US
dc.contributor.authorHilton, Aen_US
dc.contributor.authorMiles, Jen_US
dc.contributor.authorRussell, Ien_US
dc.contributor.authorChi Kei Wong, Ien_US
dc.date.accessioned2012-10-30T06:13:51Z-
dc.date.available2012-10-30T06:13:51Z-
dc.date.issued2010en_US
dc.identifier.citationBritish Journal Of General Practice, 2010, v. 60 n. 570, p. 21-27en_US
dc.identifier.issn0960-1643en_US
dc.identifier.urihttp://hdl.handle.net/10722/171394-
dc.description.abstractBackground: Pharmaceutical care serves as a collaborative model for medication review. Its use is advocated for older patients, although its cost-effectiveness is unknown. Although the accompanying article on clinical effectiveness from the RESPECT (Randomised Evaluation of Shared Prescribing for Elderly people in the Community over Time) trial finds no statistically significant impact on prescribing for older patients undergoing pharmaceutical care, economic evaluations are based on an estimation, rather than hypothesis testing. Aim: To evaluate the cost-effectiveness of pharmaceutical care for older people compared with usual care, according to National Institute for Health and Clinical Excellence (NICE) reference case standards. Method: An economic evaluation was undertaken in which NICE reference case standards were applied to data collected in the RESPECT trial. Results: On average, pharmaceutical care is estimated to cost an incremental £10 000 per additional quality-adjusted life year (QALY). If the NHS's cost-effectiveness threshold is between £20 000 and £30 000 per extra QALY, then the results indicate that pharmaceutical care is cost-effective despite a lack of statistical significance to this effect. However, the statistical uncertainty surrounding the estimates implies that the probability that pharmaceutical care is not cost-effective lies between 0.22 and 0.19. Although results are not sensitive to assumptions about costs, they differ between subgroups: in patients aged >75 years pharmaceutical care appears more cost-effective for those who are younger or on fewer repeat medications. Conclusion: Although pharmaceutical care is estimated to be cost-effective in the UK, the results are uncertain and further research into its long-term benefits may be worthwhile. ©British Journal of General Practice.en_US
dc.languageengen_US
dc.publisherRoyal College of General Practitioners. The Journal's web site is located at http://www.rcgp.org.uk/webmaster/ebjgp/journallogin.asp?OrigURL=/journal/index.aspen_US
dc.relation.ispartofBritish Journal of General Practiceen_US
dc.subjectCost-Effectivenessen_US
dc.subjectHealth Services For The Ageden_US
dc.subjectMedication Therapy Managementen_US
dc.subjectPharmaceutical Careen_US
dc.titleCost-effectiveness of shared pharmaceutical care for older patients: RESPECT trial findingsen_US
dc.typeArticleen_US
dc.identifier.emailChi Kei Wong, I:wongick@hku.hken_US
dc.identifier.authorityChi Kei Wong, I=rp01480en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.3399/bjgp09X482312en_US
dc.identifier.scopuseid_2-s2.0-76049091757en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-76049091757&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume60en_US
dc.identifier.issue570en_US
dc.identifier.spage21en_US
dc.identifier.epage27en_US
dc.identifier.isiWOS:000274611100007-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridBojke, C=6506446983en_US
dc.identifier.scopusauthoridPhilips, Z=6603428430en_US
dc.identifier.scopusauthoridSculpher, M=7006749329en_US
dc.identifier.scopusauthoridCampion, P=7006820227en_US
dc.identifier.scopusauthoridChrystyn, H=7005136151en_US
dc.identifier.scopusauthoridCoulton, S=12774928900en_US
dc.identifier.scopusauthoridCross, B=15044089300en_US
dc.identifier.scopusauthoridMorton, V=6601964625en_US
dc.identifier.scopusauthoridRichmond, S=24382167500en_US
dc.identifier.scopusauthoridFarrin, A=6603339262en_US
dc.identifier.scopusauthoridHill, G=7401964095en_US
dc.identifier.scopusauthoridHilton, A=7103389186en_US
dc.identifier.scopusauthoridMiles, J=8643445700en_US
dc.identifier.scopusauthoridRussell, I=7201981270en_US
dc.identifier.scopusauthoridChi Kei Wong, I=7102513915en_US
dc.identifier.citeulike6476004-

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