title: A cost-consequences analysis of an adherence focused pharmacist-led medication review service.
abstract: OBJECTIVE
  The aim of this project was to conduct an economic evaluation of the Norfolk Medicines Support Service (NMSS), a pharmacist-led medication review service for patients identified in primary care as non-adherent.
  
  
  METHODS
  The cost-consequences analysis was based on a before and after evaluation of the NMSS. Participants completed a self-reported adherence and health-related quality of life questionnaire prior to the review, at 6 weeks and 6 months. Service provision, prescribing and secondary care costs were considered and the mean cost before and after the intervention was calculated.
  
  
  RESULTS
  One-hundred and seventeen patients were included in the evaluation. The mean cost per patient of prescribing and hospital admissions in the 6 months prior to the intervention was £2190 and in the 6 months after intervention £1883. This equates to a mean cost saving of £307 per patient (parametric 95% confidence interval: £1269 to £655). The intervention reduced emergency hospital admissions and increased medication adherence but no significant change in health-related quality of life was observed.
  
  
  CONCLUSIONS
  The costs of providing this medication review service were offset by the reduction in emergency hospital admissions and savings in medication cost, assuming the findings of the evaluation were real and the regression to the mean phenomenon was not involved. This cost-consequences approach provides a transparent descriptive summary for decision-makers to use as the basis for resource allocation decisions.
authors.affiliation: School of Pharmacy, University of East Anglia, Norwich, UK. j.desborough@uea.ac.uk
authors.forename: James A
authors.initials: JA
authors.lastname: Desborough
authors.forename: Tracey
authors.initials: T
authors.lastname: Sach
authors.forename: Debi
authors.initials: D
authors.lastname: Bhattacharya
authors.forename: Richard C
authors.initials: RC
authors.lastname: Holland
authors.forename: David J
authors.initials: DJ
authors.lastname: Wright
mesh_terms: D000368:Aged; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005500:Follow-Up Studies; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D055118:Medication Adherence; D010593:Pharmaceutical Services / Q000191:economics / Q000458:organization & administration*; D010595:Pharmacists / Q000191:economics / Q000458:organization & administration*; D055553:Prescription Drugs / Q000008:administration & dosage* / Q000191:economics; D011320:Primary Health Care / Q000191:economics / Q000379:methods; D024382:Professional Role; D011788:Quality of Life; D011795:Surveys and Questionnaires
chemical_list: D055553:Prescription Drugs