Cost-effectiveness of pharmacy-led versus conventionally delivered antiviral treatment for hepatitis C in patients receiving opioid substitution therapy: An economic evaluation alongside a pragmatic cluster randomised trial

Myring, Gareth; Lim, Aaron G.; Hollingworth, William; McLeod, Hugh; Beer, Lewis; Vickerman, Peter; Hickman, Matthew; Radley, Andrew; Dillon, John

doi:10.1016/j.jinf.2022.09.021

Cited by 5 publications

(3 citation statements)

References 20 publications

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“…There is also considerable potential to build on the work conducted in the area of opioid use disorder to look at other aspects of healthcare for people who use drugs, for example, in the treatment of common comorbidities among those with opioid use disorder. There is a growing body of research from a broad range of countries (e.g., Australia, Malaysia, Brazil, USA, Iran, Jordan, Denmark, Cyprus, Belgium, Portugal, Pakistan, Sweden, China) [57] that has examined utilizing pharmacists to increase access to Hepatitis C screening and treatment, demonstrating that pharmacists involvement in increasing access to Hepatitis C treatment is not only effective [57,58], but also cost-effective [59]. Ideally, the body research into collaborative care for OAT can similarly extend across a range of countries, despite most work currently being limited to the USA and Australia.…”

Section: Discussionmentioning

confidence: 99%

Pharmacist-prescriber collaborative models of care for opioid use disorder: an overview of recent research

Cheetham,

Grist,

Nielsen

2024

Current Opinion in Psychiatry

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Purpose of review Collaborative models of care where pharmacists work alongside physicians have been developed for a range of physical health conditions, with benefits including improved patient outcomes and increased access to ongoing care. Opioid agonist treatment (methadone and buprenorphine) is a clinically effective and cost-effective treatment for opioid use disorder that is under-utilized in many countries due to a shortage of prescribers. In recent years, there has been increased interest in the development of collaborative models that utilize pharmacists to overcome barriers to treatment. In this article, we present a narrative review to synthesise recent work in this rapidly developing area. Recent findings Two key aspects of opioid agonist treatment were identified: Collaborative models have utilized pharmacists to facilitate buprenorphine induction, and collaborative models provide increased capacity for delivering ongoing care in a variety of settings and patient groups where prescriber access is limited. Pharmacists have undertaken direct patient care responsibilities with varying degrees of autonomy, with benefits including a reduction in prescriber workload, and improvements in treatment retention and continuity of care. Summary Collaborative models in which pharmacists are responsible for buprenorphine induction and ongoing management with methadone and buprenorphine have been shown to reduce demands on prescribers while improving or maintaining patient outcomes, and appear feasible and acceptable in a wide range of outpatient settings.

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Section: Discussionmentioning

confidence: 99%

Pharmacist-prescriber collaborative models of care for opioid use disorder: an overview of recent research

Cheetham,

Grist,

Nielsen

2024

Current Opinion in Psychiatry

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“…46 Various studies in countries or provinces with public payers have indicated that pharmacist test and treat programs for minor ailments such as uncomplicated UTIs and hepatitis C would be cost saving for the public system, illustrating the potential benefits from widespread acceptance of pharmacists as providers and the creation of sustainable reimbursement models. 37,47,48 One pilot study in England where patients had to pay out of pocket for pharmacist UTI testing and treatment service that they could have received at a national healthcare system clinic free of charge found that the majority of patients who were tested and received treatment would have gone to their general practitioner if the pharmacy service was not available. 49 United States payers should be incentivized to promote pharmacy test and treatment services for acute conditions and advocate for the removal of regulatory barriers limiting the implementation of sustainable programs.…”

Section: Payer Perspectivementioning

confidence: 99%

“…A cost‐effective analysis comparing treatment of adult group A streptococcus pharyngitis patients by community pharmacists with various physician provider treatments found pharmacist treatment to be the most cost effective using a cost threshold of $55.56 46 . Various studies in countries or provinces with public payers have indicated that pharmacist test and treat programs for minor ailments such as uncomplicated UTIs and hepatitis C would be cost saving for the public system, illustrating the potential benefits from widespread acceptance of pharmacists as providers and the creation of sustainable reimbursement models 37,47,48 . One pilot study in England where patients had to pay out of pocket for pharmacist UTI testing and treatment service that they could have received at a national healthcare system clinic free of charge found that the majority of patients who were tested and received treatment would have gone to their general practitioner if the pharmacy service was not available 49 .…”

Section: Economic and Humanistic Outcomesmentioning

confidence: 99%

Community pharmacist‐provided test and treat programs for acute infectious conditions

Koski

Klepser

Koski

et al. 2023

J Am Coll Clin Pharm

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Community pharmacists' roles have expanded in recent years to include offering test and treat programs where they perform testing on Clinical Laboratory Improvement Amendment (CLIA)‐waived point‐of‐care testing (POCT) devices to diagnose specific acute infectious conditions, such as influenza and group A streptococcus (GAS) pharyngitis, and then potentially prescribe and dispense appropriate antimicrobials. Availability of these services in pharmacies has several benefits, including increased access to care, decreased overutilization of other health care services, and decreased antimicrobial resistance. States have different requirements for collaborative practice agreements and reimbursement for these clinical services in community pharmacies. Several studies have looked at outcomes related to community pharmacies implementing test and treat programs for influenza and/or GAS. Other studies looked at outcomes related to implementing testing for SARS‐CoV‐2 and referring for treatment. Most studies described successful implementation and barriers to integration of these programs into pharmacy workflow. Some studies showed that patients want these services to be offered in community pharmacies and are willing to pay for the services. Data show that these services are cost effective compared to physician provider‐based treatment. Newer CLIA‐waived POCT technology may increase implementation of these services, but studies are needed to evaluate their utility in community pharmacies. Pharmacy schools should implement widespread training on these devices, and research should continue in this area to test the use of newer technology (i.e., multiplexed devices) and their economic impact.

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Enhancing testing and treatment uptake of HCV cascade care for the diabetes population via an integrated community-based shared care model

Hu¹,

Luh²,

Tsao³

et al. 2023

Journal of Infection

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Cost-effectiveness of pharmacy-led versus conventionally delivered antiviral treatment for hepatitis C in patients receiving opioid substitution therapy: An economic evaluation alongside a pragmatic cluster randomised trial

Cited by 5 publications

References 20 publications

Pharmacist-prescriber collaborative models of care for opioid use disorder: an overview of recent research

Pharmacist-prescriber collaborative models of care for opioid use disorder: an overview of recent research

Community pharmacist‐provided test and treat programs for acute infectious conditions

Enhancing testing and treatment uptake of HCV cascade care for the diabetes population via an integrated community-based shared care model

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