Abdulsalim Suhaj, Unnikrishnan Mazhuvancherry Kesavan, Manu Mohan K, Alsahali Saud, Alrasheedy Alian A, Martin Antony P, Godman Brian, Alfadl Abubakr A
Unaizah College of Pharmacy, Qassim University, Qassim, Saudi Arabia.
MCOPS, Manipal Academy of Higher Education, Manipal, India.
Pharmacoecon Open. 2020 Jun;4(2):331-342. doi: 10.1007/s41669-019-0172-x.
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality, especially in low- and middle-income countries (LMICs) such as India. Medicine costs are a key issue in LMICs, with typically high patient co-payments. In addition, pharmacists are underutilised in LMICs, including India. However, pharmacist-led educational interventions may improve the care of patients with COPD, as well as reduce medicine costs. Consequently, the objective of this study was to assess the effectiveness of a pharmacist-led intervention in reducing medicine costs.
We assessed the impact of a pharmacist intervention on direct medicine costs in COPD patients (medicine costs and pharmacist time) in a randomised controlled study involving an intervention and control group, conducted at a tertiary care teaching hospital in India.
The 6-monthly cost of medicines at baseline increased with disease severity, from a maximum of US$29.46 for those with mild COPD to US$63.28 for those with very severe COPD. Substantial savings in medical costs were achieved with the pharmacist-led programme, to a maximum of US$20.49 over 6 months for very severe patients. This equates to a reduction of 30.6% in medicine costs (p < 0.001), reduced to 26.1% when pharmacists' time (US$3.00/patient) was included.
There could be a key role for pharmacists as educators for COPD patients in LMICs, to improve care and reduce costs, including patient co-payments.
慢性阻塞性肺疾病（COPD）是发病和死亡的主要原因，在印度等低收入和中等收入国家（LMICs）尤为如此。药品费用是低收入和中等收入国家的一个关键问题，患者自付费用通常很高。此外，在包括印度在内的低收入和中等收入国家，药剂师的作用未得到充分发挥。然而，由药剂师主导的教育干预可能会改善慢性阻塞性肺疾病患者的护理，并降低药品费用。因此，本研究的目的是评估由药剂师主导的干预措施在降低药品费用方面的有效性。
在印度一家三级护理教学医院进行的一项随机对照研究中，我们评估了药剂师干预对慢性阻塞性肺疾病患者直接药品费用（药品费用和药剂师时间）的影响，该研究包括干预组和对照组。
基线时药品的半年费用随疾病严重程度增加，轻度慢性阻塞性肺疾病患者最高为29.46美元，极重度患者为63.28美元。通过药剂师主导的项目，医疗费用大幅节省，极重度患者在6个月内最高节省20.49美元。这相当于药品费用降低了30.6%（p<0.001），包括药剂师时间（每位患者3.00美元）时降至26.1%。
在低收入和中等收入国家，药剂师作为慢性阻塞性肺疾病患者的教育者可能发挥关键作用，以改善护理并降低成本，包括患者自付费用。
