Implementation of an interprofessional medication adherence program for chronic patients in community pharmacies: how much does it cost for the provider?

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_9880DED6F7A3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Implementation of an interprofessional medication adherence program for chronic patients in community pharmacies: how much does it cost for the provider?
Journal
BMC health services research
Author(s)
Perraudin C., Locca J.F., Rossier C., Bugnon O., Schneider M.P.
ISSN
1472-6963 (Electronic)
ISSN-L
1472-6963
Publication state
Published
Issued date
08/01/2019
Peer-reviewed
Oui
Volume
19
Number
1
Pages
15
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
The implementation of an innovative and sustainable professional pharmacy service in routine care requires substantial resources borne by the pharmacy owner. Although a community pharmacy is a business setting, few studies have examined cost as a potential barrier to widespread implementation. Implementation costs, as the cost impact of an implementation effort, can be significant and hamper the decision to invest from the provider perspective. Traditional financial planning tools can be used to analyse and support business decision to implement a service by assessing the net impact of a new service on the provider's budget. This study aimed to estimate the implementation costs and the break-even point of an interprofessional medication adherence program for chronic patients in Switzerland. The program combines motivational interviews, medication adherence electronic monitoring and feedback reports to patient and physicians.
We used a 3-step approach: (i) micro-costing analysis: identification of implementation activities, quantification and valuation of required resources. Implementation costs, including service support costs and direct delivery costs, were analysed according to the implementation phase (installation, initial implementation, and full operation); (ii) break-even analysis: estimation of the required number of patients to follow up with to ensure that the generated revenue exceeded the total cost; and (iii) univariate sensitivity analyses.
The estimated total cost of the installation phase was 8481 CHF, more than half of which represented the cost of the equipment. Direct delivery costs were 666 CHF per patient per year, with 68% of this value associated with the cost of workforce time. According to the Swiss national reimbursement system, a minimal of 16 [10-27] patients was required to cover the implementation costs of the installation phase. This break-even point decreased to 13 patients in the initial and full operation phases.
These estimates lead to a better understanding of the real cost of implementing a professional pharmacy service in routine care. In a Swiss context, the current medication adherence support fee-for-service system allows pharmacists to reach the break-even point. Such information is important for community pharmacists to guide their implementation strategies. The replication of similar analyses in other settings and countries is paramount.
Keywords
Chronic Disease/economics, Community Pharmacy Services/economics, Community Pharmacy Services/organization & administration, Health Care Costs, Health Resources, Health Services Research, Humans, Interprofessional Relations, Medication Adherence/statistics & numerical data, Medication Therapy Management/economics, Medication Therapy Management/organization & administration, Pharmacists, Physicians, Program Development/economics, Switzerland, Break-even analysis, Community pharmacy, Cost analysis, IMAP, Implementation, Medication adherence
Pubmed
Web of science
Open Access
Yes
Create date
19/01/2019 9:05
Last modification date
20/08/2019 16:00
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