Key points are not available for this paper at this time.
BACKGROUND: Adding pharmacists to primary care teams significantly improved blood pressure control and reduced predicted 10-year cardiovascular risk in patients with Type 2 diabetes. This pre-specified sub-study evaluated the economic implications of this cardiovascular risk reduction strategy. METHODS: One-year outcomes and healthcare utilization data from the trial were used to determine cost-effectiveness from the public payer perspective. Costs were expressed in 2014 Canadian dollars and effectiveness was based on annualized risk of cardiovascular events derived from the UKPDS Risk Engine. RESULTS: The 123 evaluable trial patients included in this analysis had a mean age of 62 (± 11) years, 38% were men, and mean diabetes duration was 6 (± 7) years. Pharmacists provided 3. 0 (± 1. 9) hours of additional service to each intervention patient, which cost 226 (± 1143) per patient. The overall one-year per-patient costs for healthcare utilization were 190 lower in the intervention group compared with usual care [95% confidence interval (CI): -1040, 668). Intervention patients had a significant 0. 3% greater reduction in the annualized risk of a cardiovascular event (95% CI: 0. 08%, 0. 6%) compared with usual care. In the cost-effectiveness analysis, the intervention dominated usual care in 66% of 10, 000 bootstrap replications. At a societal willingness-to-pay of 4000 per 1% reduction in annual cardiovascular risk, the probability that the intervention was cost-effective compared with usual care reached 95%. A sensitivity analysis using multiple imputation to replace missing data produced similar results. CONCLUSIONS: Within a randomized trial, adding pharmacists to primary care teams was a cost-effective strategy for reducing cardiovascular risk in patients with Type 2 diabetes. In most circumstances, this intervention may also be cost saving.
Simpson et al. (Fri,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: