Fast-Track Medication Refill (FTMR) Service Could Be More Cost-Effective Than The Current Model Of Care In Hong Kong

• Published in: Value in health Vol. 20; no. 9; p. A519
• Main Authors: Lee, VW, Kwan, WH, Ko, XC, Yan, BP
• Format: Journal Article
• Language: English
• Published: Lawrenceville Elsevier Science Ltd 01.10.2017
• Subjects: Cardiovascular disease; Cardiovascular diseases; Clinical research; Clinical trials; Clinics; Cost analysis; Cost control; Drugs; GDP; Gross Domestic Product; Hospitalization; Hypertension; Medical treatment; Patients; Pharmacists; Quality adjusted life years; Savings; Willingness to pay; Hong Kong China; China
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2017.08.680

OBJECTIVES: This study compared the cost-effectiveness of the hypothetical FTMR service, where cardiovascular disease patients not requiring any medication change from a follow-up visit could obtain their refill medications from pharmacists directly, with the current model of care in Special Out-Patient Clinics under the Hospital Authority in Hong Kong. METHODS: The ten-year costs per person, including hospitalization and running costs, and the quality-adjusted life-years (QALY) associated with the proposed FTMR model with a follow-up frequency of either every 3 or 6 months and the current model of care as the base case were estimated by a Markov model. Model inputs were derived from characteristics of patients attending the Hypertension Clinic in Prince of Wales Hospital from April 2016 to March 2017 and from clinical trials published in the literature. The outcome measure was incremental cost per QALY gained (ICER). RESULTS: Using the Gross Domestic Product (GDP) per capita of Hong Kong (USD 43496.54) as the willingness-to-pay per QALY, an every-3-month FTMR was more cost-effective than the current model, with an average follow-up duration of 22.77 weeks with an ICER of United States Dollar (USD) 28,300 and a QALY gain of 0.07 year while an every-6-month FTMR dominated over the current model by offering both cost savings of USD 289 and QALY gain of 0.009 year. An every-3-month FTMR was more cost-effective than an every-6-month FTMR with an ICER of USD 37,200 and a QALY gain of 0.06 year. CONCLUSIONS: The hypothetical FTMR service was shown to be a cost-effective choice for stable patients to have their chronic medications refilled compared with the current model of care in Special Out-Patient Clinics in Hong Kong. The implementation of an every-3-month FTMR also fosters a closer therapeutic monitoring in this patient population.