Social and economic value of Portuguese community pharmacies in health care

Abstract

BackgroundCommunity pharmacies are major contributors to health care systems across the world. Several studies have been conducted to evaluate community pharmacies services in health care. The purpose of this study was to estimate the social and economic benefits of current and potential future community pharmacies services provided by pharmacists in health care in Portugal.MethodsThe social and economic value of community pharmacies services was estimated through a decision-model. Model inputs included effectiveness data, quality of life (QoL) and health resource consumption, obtained though literature review and adapted to Portuguese reality by an expert panel. The estimated economic value was the result of non-remunerated pharmaceutical services plus health resource consumption potentially avoided. Social and economic value of community pharmacies services derives from the comparison of two scenarios: “with service” versus “without service”.ResultsIt is estimated that current community pharmacies services in Portugal provide a gain in QoL of 8.3% and an economic value of 879.6 million euros (M€), including 342.1 M€ in non-remunerated pharmaceutical services and 448.1 M€ in avoided expense with health resource consumption. Potential future community pharmacies services may provide an additional increase of 6.9% in QoL and be associated with an economic value of 144.8 M€: 120.3 M€ in non-remunerated services and 24.5 M€ in potential savings with health resource consumption.ConclusionsCommunity pharmacies services provide considerable benefit in QoL and economic value. An increase range of services including a greater integration in primary and secondary care, among other transversal services, may add further social and economic value to the society.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2525-4) contains supplementary material, which is available to authorized users.

<p>A systematic review and meta-analysis of the impact of collaborative practice between community pharmacist and general practitioner on asthma management</p>

“…Community pharmacists (CPs) represent a conspicuous part of pharmacist fraternity, who are equally trained, thoroughly skilled, and well qualified. Recently in developed countries, CPs have been involved in direct patient care for health promotion and medication management services in various chronic diseases, such as hypertension, diabetes, and asthma. 11 The expanded role of CPs in patient’s education, adherence support, and medication therapy management becomes more important as asthma involves a chronic cycle, specialized devices, periodic assessments, self-monitoring, and an individualized therapeutic plan, and CPs have vast potential to provide these interventions 12,13…”

Perceived barriers to the implementation of clinical pharmacy services in a metropolis in Northeast Brazil

“…In this way, the CPS have expanded in different settings into the health systems [ 8 – 10 ]. In Brazil it would not be different, because CPS have been implemented in the Brazilian Health System (SUS) in the last ten years [ 11 , 12 ].…”

Diabetes policies and pharmacy-based diabetes interventions in Portugal: a comprehensive review

“…blood glucose measurements A ssessment: Drug Related Problems (DRPs) P lan: e.g. referral to physician, patient education and informationObservational - process indicators of Diabetes Management Program (2004–2008)356 in 2005379 in 20081294 in 2005Pilger D (2007) [37]Screening of individuals at risk of diabetesScreening patients with > 45 years and another risk factor for diabetes: blood glucose measurement and referral to physician as per intervention protocolDescriptive cross-sectional study (2005)8229Horta MR (2010) [38]Screening of uncontrolled diabetic patientsScreening patients on diabetes medications: blood glucose measurement, reinforcing adherence and self-monitoring, and referral to physician as per intervention protocolDescriptive cross-sectional evaluation of nationwide campaign (2007)7237719ES Research (2009) [39]Screening of uncontrolled diabetic patientsScreening patients on diabetes medications: blood glucose measurement, reinforcing adherence and self-monitoring, and referral to physician as per intervention protocolEconomic evaluation of nationwide campaign (2007)7237719Jacinto I (2016) [48]Screening of individuals at risk of diabetesPromoting FINDRISK test to all adult non-diabetic individuals (except pregnant women) and healthy lifestyle habits, referral to physician if score > 15 points.Descriptive cross-sectional evaluation of regional campaign (2015)2257007Paulino E (2017) [49]Screening of individuals at risk of diabetes and diabetes management1) Promoting FINDRISK test to all individuals and referral of high-risk patients to pharmacy services, to physician or re-evaluation in 1 year, as appropriate2) Follow-up of diabetic patients with assessment of health problems, reinforcing adherence, referral to other providers or to pharmacy consultationsDescriptive cross-sectional evaluation of regional initiative (2016/17)1) 262) 311) 1962) 106Félix J 2017 [52]Screening of individuals at risk, screening of uncontrolled diabetic patients, and diabetes managementIncludes the interventions of studies [31, 32, 35, 38] (Economic study partially based on data of these studies) Economic evaluation (decision-model)NA (model-based)NA (model-based) NR not reported, NA not applicable…”

“…In 2016, Felix et al estimated the social and economic benefits of Portuguese pharmacy public health interventions based on volume data of services provided in the last 25 years [ 52 ]. The annual economic value of promoting adherence, although not limited to diabetes, was estimated at 237.6 million euros, and that of direct interventions in diabetes was estimated at 32.9 million euros (15.8% of all pharmacy-based disease interventions).…”