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. 2020 Jun;4(2):331-342.
doi: 10.1007/s41669-019-0172-x.

Impact of a Clinical Pharmacist Intervention on Medicine Costs in Patients with Chronic Obstructive Pulmonary Disease in India

Suhaj Abdulsalim  1   2 , Mazhuvancherry Kesavan Unnikrishnan  2   3 , Mohan K Manu  4 , Saud Alsahali  1 , Alian A Alrasheedy  1 , Antony P Martin  5   6 , Brian Godman  7   8   9   10 , Abubakr A Alfadl  1
Affiliations

Impact of a Clinical Pharmacist Intervention on Medicine Costs in Patients with Chronic Obstructive Pulmonary Disease in India

Suhaj Abdulsalim et al. Pharmacoecon Open. 2020 Jun.

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality, especially in low- and middle-income countries (LMICs) such as India. Medicine costs are a key issue in LMICs, with typically high patient co-payments. In addition, pharmacists are underutilised in LMICs, including India. However, pharmacist-led educational interventions may improve the care of patients with COPD, as well as reduce medicine costs. Consequently, the objective of this study was to assess the effectiveness of a pharmacist-led intervention in reducing medicine costs.

Methodology: We assessed the impact of a pharmacist intervention on direct medicine costs in COPD patients (medicine costs and pharmacist time) in a randomised controlled study involving an intervention and control group, conducted at a tertiary care teaching hospital in India.

Results: The 6-monthly cost of medicines at baseline increased with disease severity, from a maximum of US$29.46 for those with mild COPD to US$63.28 for those with very severe COPD. Substantial savings in medical costs were achieved with the pharmacist-led programme, to a maximum of US$20.49 over 6 months for very severe patients. This equates to a reduction of 30.6% in medicine costs (p < 0.001), reduced to 26.1% when pharmacists' time (US$3.00/patient) was included.

Conclusion: There could be a key role for pharmacists as educators for COPD patients in LMICs, to improve care and reduce costs, including patient co-payments.

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Conflict of interest statement

Suhaj Abdulsalim, Mazhuvancherry Kesavan Unnikrishnan, Mohan K. Manu, Saud Alsahali, Alian A. Alrasheedy, Antony P. Martin, Brian Godman, and Abubakr A Alfadl declare that they have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Flow chart indicating patient numbers at different stages of the study
Fig. 2
Fig. 2
Medicines prescribed in each group (CG and IG) as a percentage of the total medicines prescribed (items). CG control group, IG intervention group
Fig. 3
Fig. 3
Box plot of medicine cost comparisons between the intervention and control groups at baseline [median (IQR)]. IQR interquartile range
Fig. 4
Fig. 4
Box plot of medicine cost comparison between the intervention and control groups at 12 months [median (IQR)]. IQR interquartile range
Fig. 5
Fig. 5
Box plot of medicine cost comparison between the intervention and control groups at 24 months [median (IQR)]. IQR interquartile range
See this image and copyright information in PMC

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