ABSTRACT

Background

Cardiovascular diseases (CVDs) are responsible for one third of global deaths and the main cause of death among Jordanians. Pharmacist-led care was outlined previously as a cost-effective approach in the management of chronic illness; however, this is not well studied in low to middle-income countries.

Aim and objectives

To assess the cost-effectiveness of pharmacist-led care versus usual care in preventing CVDs in Type 2 Diabetes Mellitus (T2DM).

Method

A Markov model of one-year cycle length and 10-year time horizon was constructed to simulate 10-year CVD events, mortality, and costs for two hypothetical cohorts; usual care and pharmacist-led care, respectively, of Jordanian patients suffering from T2DM. Public health provider perspective was adopted. Outcomes examined were incremental costs, LYGs, and incremental cost-effectiveness ratio (ICER). Deterministic and probabilistic sensitivity analysis (PSA) assessed the robustness of the results.

Result

The pharmacist-led care generated an additional 0.3 LYG/patient at an additional cost of JD1,238.78 (US$1,747.24) comparing to the usual care in the 10-year base-case analysis. Deterministic and PSA supported the robustness of base-case findings, indicating that pharmacist-led care is cost-effective.

Conclusion

The findings outline long-term clinical and economic benefits of expanding clinical pharmacist’s roles in direct patient care services.

中文翻译：

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在 2 型糖尿病约旦人中，药剂师主导的护理与常规护理的成本效益：心血管疾病预防的马尔可夫模型

摘要

背景

心血管疾病 (CVDs) 占全球死亡人数的三分之一，也是约旦人的主要死因。以前，药剂师主导的护理被概述为一种具有成本效益的慢性病管理方法；然而，这在中低收入国家没有得到很好的研究。

宗旨和目标

评估药剂师主导的护理与常规护理在预防 2 型糖尿病 (T2DM) 心血管疾病方面的成本效益。

方法

构建了一个一年周期长度和 10 年时间范围的马尔可夫模型，以模拟两个假设队列的 10 年 CVD 事件、死亡率和成本；分别为患有 T2DM 的约旦患者提供常规护理和药剂师主导的护理。采纳了公共卫生提供者的观点。检查的结果是增量成本、LYGs 和增量成本效益比 (ICER)。确定性和概率敏感性分析 (PSA) 评估了结果的稳健性。

结果

与 10 年基本案例分析中的常规护理相比，药剂师主导的护理产生了额外的 0.3 LYG/患者，额外费用为 1,238.78 约旦第纳尔（1,747.24 美元）。确定性和 PSA 支持基本案例结果的稳健性，表明药剂师主导的护理具有成本效益。

结论

研究结果概述了扩大临床药剂师在直接患者护理服务中的作用的长期临床和经济效益。