title: A pharmacoeconomic model to aid in the allocation of ambulatory clinical pharmacy services.
abstract: Drugs of choice in secondary prevention strategies reduce complication rates of certain diseases. Unfortunately, these strongly indicated drugs remain underused. A model was developed to predict the cost-effectiveness of clinical pharmacy services assumed to improve use of drugs of choice to unity in hypothetical cohorts of three diseases that commonly accompany hypertension and in which clear drugs of choice exist. Use of angiotensin-converting enzyme (ACE) inhibitors in patients with diabetes who have proteinuria, use of beta blockers after myocardial infarction, and use of ACE inhibitors in patients with asymptomatic left ventricular dysfunction were analyzed. Clinical pharmacy services could be cost-saving in all three diseases in this model if use of the drug of choice in standard practice did not exceed 0.899 in patients with diabetes who have proteinuria, 0.512 in patients after infarct, and 0.804 in patients with asymptomatic left ventricular dysfunction. This model may help decision makers by accessing local patient demographics and prescribing habits before any resource allocation.
authors.affiliation: Department of Medicine, State University of New York Health Sciences Center at Syracuse, 13210, USA.
authors.forename: D F
authors.initials: DF
authors.lastname: Lehmann
authors.forename: J J
authors.initials: JJ
authors.lastname: Medicis
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000554:Ambulatory Care Facilities / Q000191:economics*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D003327:Coronary Disease / Q000188:drug therapy; D003361:Cost Allocation; D003362:Cost-Benefit Analysis; D017850:Economics, Pharmaceutical; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D018803:Models, Economic; D010593:Pharmaceutical Services / Q000191:economics*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors