Medication review with follow-up for cardiovascular outcomes: a trial based cost-utility analysis

Lay abstract Aim: To assess if a pharmacy service called 'medication review' represents value for money to the Chilean healthcare system. Materials & methods: A trial that included older adults, receiving five or more medications, with moderate to high risk of having events such as strokes or heart attack was conducted. A cost-effectiveness analysis was performed comparing the costs and the benefits of the intervention with usual care. Results: At the end of the trial, 146 patients were on the intervention group, whereas 145 were on the control group. Medication review generated more costs, but also increased benefits. Conclusion: Medication review was good value for money for the Chilean healthcare system. Aim: To assess the trial-based cost-effectiveness of medication review with follow-up compared with usual care in primary care. Materials & methods: A cluster randomized controlled trial included patients if they were independent older adults, receiving five or more prescriptions, with moderate or high cardiovascular risk. Costs were estimated from the public healthcare sector perspective, and health benefits were measured as quality-adjusted life years. Both of which were used to calculate the incremental cost-effectiveness ratio. Results: Twelve centers completed the study, six (146 patients) in the intervention group and six (145 patients) in the control group. The base-case analysis showed an incremental cost-effectiveness ratio of US$ (2019) 434.4/quality-adjusted life year (95% CI 64.20-996.03). Conclusion: The intervention was cost-effective in the public primary care setting.