MS & PHD STUDENTS
EducationB.S, Pharmaceutical Sciences (2008) Chulalongkorn University, Bangkok, Thailand
Methods: A cost-effectiveness decision analytic model was developed using a health care system perspective based on published clinical trials. Costs included direct medical costs, and the effectiveness unit was patients discharged without suffering a subsequent adverse drug event. A systematic review of published studies was conducted to estimate variable probabilities in the cost-effectiveness model. To test the robustness of the results, a second-order probabilistic sensitivity analysis (Monte Carlo simulation) was used to run 10 000 cases through the model sampling across all distributions simultaneously.
Results: Pharmacist counseling at hospital discharge provided a small, but statistically significant, clinical improvement at a similar overall cost. Pharmacist counseling was cost saving in approximately 48% of scenarios and in the remaining scenarios had a low willingness-to-pay threshold for all scenarios being cost-effective. In addition, discharge counseling was more cost-effective in the high-risk elderly population compared to the general population.
Conclusion: This cost-effectiveness analysis suggests that discharge counseling by pharmacists is quite cost-effective and estimated to be cost saving in over 48% of cases. High-risk elderly patients appear to especially benefit from these pharmacist services.
1. Chinthammit C, Armstrong EP, and Warholak TL. A Cost-Effectiveness Evaluation of Hospital Discharge Counseling by Pharmacists. Journal of Pharmacy Practice 2011, published on October 10, 2011.
2. Euasobhon P, Chaudakshetrin P, Rushatamukayanunt P, Mandee S, Chinthammit C. "Incidence and Treatment Strategies of Neuropathic Pain: The Tertiary Care Setting’s Experience." Siriraj Medical Journal 65.5 (2013): 123-127.
3. Chinthammit C. (2014) A Single-Blind, Randomized Controlled Study of Efficacy and Effectiveness of Pharmacy Quality Improvement.
4. Chinthammit C, Armstrong EP, PharmD, Boesen K, Martin R, Taylor AM, Warholak TL. Cost-Effectiveness of Comprehensive Medication Reviews Versus Noncomprehensive Medication Review Interventions and Subsequent Successful Medication Changes in a Medicare Part D Population. Journal of manages care and specialty pharmacy 21.5 (2015): 381-389.