Apotheka Mustamäe Apteek OÜ, Laagri Ärimaja, Vae 16, Laagri, Harjumaa, 76401, Estonia.
Stockholm School of Economics in Riga, Strēlnieku iela 4a, Rīga, LV-1010, Latvia.
BMC Health Serv Res. 2024 Sep 27;24(1):1119. doi: 10.1186/s12913-024-11504-z.
The aim of this study is to assess the cost savings from medication reviews conducted for individuals living in nursing homes in Estonia. Medication reviews performed as part of the automated dose dispensing (ADD) service by community pharmacies might help identify suboptimal medicine regimens.
We use a case study approach to identify suboptimal use of medication in treatment plans and estimate the potential cost saving from medication reviews. To achieve this, we assess 101 treatment plans submitted for medication review by nursing homes in Estonia between 2021 and 2023. Additionally, we run OLS regressions to identify the most important determinants of medication cost savings.
We estimate an average direct cost saving of €43.62 per patient per year, which corresponds to 8.27% of the average annual medication costs. If medication reviews were conducted for all elderly individuals over 75 years old who use six or more prescription medicines, nearly 2% of Estonia's pharmaceutical budget could be saved. Regression analysis indicates that the most significant contributors to these cost savings are suboptimal use of generics, incorrect dosages (too high), and the elimination of incorrect medications.
Our study suggests that annual medication reviews conducted as part of the ADD service might help reduce medication expenditure when offered to a wider public.
本研究旨在评估爱沙尼亚养老院居民进行药物审查所节省的费用。社区药房提供的自动剂量配药（ADD）服务中进行的药物审查可能有助于发现药物方案的不足。
我们采用案例研究的方法来确定治疗计划中药物使用的不足，并估算药物审查的潜在节省成本。为此，我们评估了 2021 年至 2023 年间爱沙尼亚养老院提交的 101 份药物审查治疗计划。此外，我们还进行了 OLS 回归分析，以确定节省药物成本的最重要决定因素。
我们估计每位患者每年的直接成本平均节省 43.62 欧元，这相当于平均年度药物费用的 8.27%。如果对所有使用六种或六种以上处方药的 75 岁以上老年人进行药物审查，爱沙尼亚的药品预算可能会节省近 2%。回归分析表明，这些节省成本的最重要因素是通用名药物使用不当、剂量不正确（过高）以及消除不正确的药物。
我们的研究表明，ADD 服务中进行的年度药物审查可能有助于在更广泛的公众中减少药物支出。
