Economic evaluation of home medication review by community pharmacists (HMR-CP) for patients with type 2 diabetes mellitus (T2DM).
OBJECTIVE
Home medication review (HMR) programs could minimise patients' health-related costs and burdens, thereby enhancing the quality of life and well-being. The aim of this economic evaluation is to determine if home medication review by community pharmacists (HMR-CP) for patients with type 2 diabetes mellitus (T2DM) is a cost-effective intervention from the Malaysian healthcare provider perspective.


METHODS
The economic evaluation was conducted alongside the randomised controlled trial (RCT) to estimate the intermediate cost-effectiveness of HMR-CP for patients with T2DM. A Markov model was then constructed to project the lifetime cost-effectiveness data beyond the RCT. The primary outcomes for the economic evaluation were HbA1c and quality-adjusted life-years (QALYs).


RESULTS
The intervention and health services costs throughout the 6-month HMR-CP trial were RM121.45 (USD28.64) [95%CI: RM115.89 to 127.08 (USD27.33-29.97)] per participant. At a 6-month follow-up, a significant reduction in HbA1c of 0.902% (95% CI: 0.388% to 1.412%) was noted in the HMR-CP group compared to the control group. The ICER of HMR-CP intervention versus standard care was RM178.82 (USD 42.17) [95%CI: RM86.77-364.03 (USD20.46-85.86)] per reduction of HbA1c. HMR-CP intervention [RM12,764.82 (USD3010.57)] was associated with an incremental cost of RM83.34 (USD19.66) over control group [RM12,682.95 (USD2,991.26)] with an additional of 0.07 QALY gained. The ICER associated with HMR-CP intervention was RM1,190.57 (USD280.79) per QALY gained, which was below the ICER threshold in Malaysia, indicating that HMR-CP was a cost-effective option.


CONCLUSION
HMR-CP was a cost-effective intervention that had significantly reduced the HbA1c among the T2DM patients, although associated with higher mean total costs per participant.
['Rosli|Mohd Rozaini|MR|', 'Wu|David Bin-Chia|DB|', 'Neoh|Chin Fen|CF|https://orcid.org/0000-0003-2462-2958', 'Karuppannan|Mahmathi|M|https://orcid.org/0000-0002-6503-3191']
D003362:Cost-Benefit Analysis D003924:Diabetes Mellitus, Type 2 D006801:Humans D010595:Pharmacists D011788:Quality of Life D019057:Quality-Adjusted Life Years
home medication review diabetes C51 - Model Construction and Estimation Cost-utility Z19 - Other pharmacy