Impact of a Clinical Pharmacist Intervention on Medicine Costs in Patients with Chronic Obstructive Pulmonary Disease in India

Abstract

Background Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality, especially in lowand 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. Methodology 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. Results 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. Conclusion 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.

Availability and price changes of potential medicines and equipment for the prevention and treatment of COVID-19 among pharmacy and drug stores in Bangladesh; findings and implications

“…Pharmacists and similar healthcare professionals in Bangladesh can prevent and manage patients with COVID-19 as well as help address unintended consequences 121,122 . This includes addressing issues of availability, access, and adherence to medicines in patients with chronic NCDs during the pandemic [123][124][125][126][127][128][129] . Potential activities also include giving guidance on prevention and possible treatments of COVID-19 based on evidence rather than misinformation as well as reinforcing Government messages to prevent the spread of COVID-19, including purchasing personal protection equipment (PPE) 122,[130][131][132][133] .…”

Utilisation, Availability and Price Changes of Medicines and Protection Equipment for COVID-19 Among Selected Regions in India: Findings and Implications

“…In view of the contribution of the costs of medicines to total healthcare costs in India, coupled with existing high co-payments for visiting physicians and funding medicines, community pharmacies have and will continue to play an appreciable role in managing patients in India ( Abdulsalim et al, 2018 ; Daftary et al, 2019 ; Nafade et al, 2019 ; Abdulsalim et al, 2020 ; Sousa Pinto et al, 2020 ). Key reasons include avoiding paying physician fees, especially for milder symptoms, accessibility with long opening hours, and a lack of queues compared with ambulatory care clinics ( Soumya et al, 2016 ; Mohathasim Billah and Venkatesan, 2017 ; Daftary et al, 2019 ).…”

Chronic Obstructive Pulmonary Disease Treatment and Pharmacist-Led Medication Management

“…105,[107][108][109][110][111] In addition, the pharmacists as educators for COPD patients could also reduce medical costs, smoking behavior, and the frequency of lung deterioration. [112][113][114] These clinical practices demonstrated that the pharmaceutical care had shown favourable impacts on addressing drug-related problems such as medication adherence, hospital admission and medical costs, thus supporting its vital role in the management of COPD, especially when there is a wide range of therapeutic agents.…”