VALMER (the Economic Value of Home Medicines Reviews)


Project Details
Project ID: IIG-021
Type: Investigator Initiated
Status: Completed
Institution: University of Tasmania
Chief Investigator: Dr Peter Tenni

Project Summary

Objective: Since the introduction of the Home Medicines Review (HMR) program in 2001, there has been limited study into their economic outcomes. The objective of this study was to investigate the economic outcomes of HMRs.

Methods: An observational cohort study was conducted across all states in Australia. Pharmacists accredited to perform HMRs submitted data relating to HMRs performed in 2008. A sample of 180 HMRs was analysed by panels of experts (pharmacists and medical practitioners) to model the potential economic outcomes in terms of savings to the healthcare system and quality of life. A time horizon of 12 months was used for all projections. Assumptions in the model were tested via sensitivity analysis in alternate scenarios.

Results and Discussion: Data regarding 661 HMRs were submitted by 149 pharmacists. The HMR reports documented 2323 drug-related problems for which the pharmacists made 2727 recommendations to resolve. Comparatively few DRPs relating to patient Education or information were documented. The potential savings resulting from individual HMRs varied considerably. Savings resulted from significant reductions in drug costs (P=0.04) and potential health resource utilisation based on the expert panel’s estimates (P<0.001). Substantially greater savings were found in a subset of the HMRs- in the upper quartile (based on savings), the average predicted saving per HMR offset the cost of the HMR. The alternate scenarios indicated a high probability of cost effectiveness at a threshold of $50 000 per QALY gained.

Conclusions: Despite the short duration of follow-up (12 months), it was demonstrated that HMRs are cost effective in many patients; however, the benefits resulting from some HMRs are limited. A longer duration of follow-up would potentially have demonstrated cost effectiveness in many of these patients. Improvements in targeting patients who would benefit more from HMRs may also improve the cost effectiveness of the HMR program. Further limitations to the study included minimal assessment of potentially valuable education and counselling provided during the HMR interview.

Project ID: IIG-021 Type: Investigator Initiated Grant Status: Completed Institution: University of Tasmania Chief Investigator: Dr Peter Tenni