Cost-effectiveness of pharmacist-led care versus usual care in type 2 diabetic Jordanians: a Markov modeling of cardiovascular diseases prevention

Abstract

ABSTRACT Background Cardiovascular diseases (CVDs) are responsible for one third of global deaths and the main cause of death among Jordanians. Pharmacist-led care was outlined previously as a cost-effective approach in the management of chronic illness; however, this is not well studied in low to middle-income countries. Aim and objectives To assess the cost-effectiveness of pharmacist-led care versus usual care in preventing CVDs in Type 2 Diabetes Mellitus (T2DM). Method A Markov model of one-year cycle length and 10-year time horizon was constructed to simulate 10-year CVD events, mortality, and costs for two hypothetical cohorts; usual care and pharmacist-led care, respectively, of Jordanian patients suffering from T2DM. Public health provider perspective was adopted. Outcomes examined were incremental costs, LYGs, and incremental cost-effectiveness ratio (ICER). Deterministic and probabilistic sensitivity analysis (PSA) assessed the robustness of the results. Result The pharmacist-led care generated an additional 0.3 LYG/patient at an additional cost of JD1,238.78 (US$1,747.24) comparing to the usual care in the 10-year base-case analysis. Deterministic and PSA supported the robustness of base-case findings, indicating that pharmacist-led care is cost-effective. Conclusion The findings outline long-term clinical and economic benefits of expanding clinical pharmacist’s roles in direct patient care services.