Cost effectiveness of support for people starting a new medication for a long term condition through community pharmacies: an economic evaluation of the New Medicine Service (NMS) compared with normal practice
Background: The English community pharmacy New Medicine Service (NMS) significantly increases patient adherence to medicines, compared with normal practice. We examined the cost-effectiveness of NMS compared with normal practice by combining adherence improvement and intervention costs with the effe...
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| Format: | Article |
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Springer
2017
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| Online Access: | https://eprints.nottingham.ac.uk/44314/ |
| _version_ | 1848796888106532864 |
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| author | Elliott, Rachel A. Tanajewski, Lukasz Gkountouras, Georgios Avery, Anthony J. Barber, Nick Mehta, Rajnikant Boyd, Matthew J. Latif, Asam Chuter, Antony Waring, Justin |
| author_facet | Elliott, Rachel A. Tanajewski, Lukasz Gkountouras, Georgios Avery, Anthony J. Barber, Nick Mehta, Rajnikant Boyd, Matthew J. Latif, Asam Chuter, Antony Waring, Justin |
| author_sort | Elliott, Rachel A. |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background: The English community pharmacy New Medicine Service (NMS) significantly increases patient adherence to medicines, compared with normal practice. We examined the cost-effectiveness of NMS compared with normal practice by combining adherence improvement and intervention costs with the effect of increased adherence on patient outcomes and healthcare costs.
Methods: We developed Markov models for diseases targeted by the NMS (hypertension, type 2 diabetes, chronic obstructive pulmonary disease, asthma and antiplatelet regimens) to assess the impact of patients’ non-adherence. Clinical event probability, treatment pathway, resource-use and costs were extracted from literature and costing tariffs. Incremental costs and outcomes associated with each disease were incorporated additively into a composite probabilistic model and combined with adherence rates and intervention costs from the trial. Costs per extra quality-adjusted-life-year(QALY) were calculated from the perspective of NHS England, using a lifetime horizon.
Results: NMS generated a mean of 0.05 (95%CI: 0.00, 0.13) more QALYs per patient, at a mean reduced cost of -£144 (95%CI: -769, 73). The NMS dominates normal practice with probability of 0.78 (ICER: - £3166 per QALY). NMS has a 96.7% probability of cost-effectiveness compared with normal practice at a willingness-to-pay of £20000 per QALY. Sensitivity analysis demonstrated that targeting each disease with NMS has a probability over 0.90 of cost-effectiveness compared with normal practice at a willingness-to-pay of £20000 per QALY.
Conclusions: Our study suggests that the New Medicine Service increased patient medicine adherence compared with normal practice, which translated into increased health gain at reduced overall cost. |
| first_indexed | 2025-11-14T19:55:08Z |
| format | Article |
| id | nottingham-44314 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T19:55:08Z |
| publishDate | 2017 |
| publisher | Springer |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-443142020-05-04T18:59:12Z https://eprints.nottingham.ac.uk/44314/ Cost effectiveness of support for people starting a new medication for a long term condition through community pharmacies: an economic evaluation of the New Medicine Service (NMS) compared with normal practice Elliott, Rachel A. Tanajewski, Lukasz Gkountouras, Georgios Avery, Anthony J. Barber, Nick Mehta, Rajnikant Boyd, Matthew J. Latif, Asam Chuter, Antony Waring, Justin Background: The English community pharmacy New Medicine Service (NMS) significantly increases patient adherence to medicines, compared with normal practice. We examined the cost-effectiveness of NMS compared with normal practice by combining adherence improvement and intervention costs with the effect of increased adherence on patient outcomes and healthcare costs. Methods: We developed Markov models for diseases targeted by the NMS (hypertension, type 2 diabetes, chronic obstructive pulmonary disease, asthma and antiplatelet regimens) to assess the impact of patients’ non-adherence. Clinical event probability, treatment pathway, resource-use and costs were extracted from literature and costing tariffs. Incremental costs and outcomes associated with each disease were incorporated additively into a composite probabilistic model and combined with adherence rates and intervention costs from the trial. Costs per extra quality-adjusted-life-year(QALY) were calculated from the perspective of NHS England, using a lifetime horizon. Results: NMS generated a mean of 0.05 (95%CI: 0.00, 0.13) more QALYs per patient, at a mean reduced cost of -£144 (95%CI: -769, 73). The NMS dominates normal practice with probability of 0.78 (ICER: - £3166 per QALY). NMS has a 96.7% probability of cost-effectiveness compared with normal practice at a willingness-to-pay of £20000 per QALY. Sensitivity analysis demonstrated that targeting each disease with NMS has a probability over 0.90 of cost-effectiveness compared with normal practice at a willingness-to-pay of £20000 per QALY. Conclusions: Our study suggests that the New Medicine Service increased patient medicine adherence compared with normal practice, which translated into increased health gain at reduced overall cost. Springer 2017-08-03 Article PeerReviewed Elliott, Rachel A., Tanajewski, Lukasz, Gkountouras, Georgios, Avery, Anthony J., Barber, Nick, Mehta, Rajnikant, Boyd, Matthew J., Latif, Asam, Chuter, Antony and Waring, Justin (2017) Cost effectiveness of support for people starting a new medication for a long term condition through community pharmacies: an economic evaluation of the New Medicine Service (NMS) compared with normal practice. PharmacoEconomics, 35 (12). pp. 1237-1255. ISSN 1170-7690 Long term condition Medicines adherence Community pharmacy Randomised controlled trial Economic evaluation Markov modelling https://link.springer.com/article/10.1007/s40273-017-0554-9 doi:10.1007/s40273-017-0554-9 doi:10.1007/s40273-017-0554-9 |
| spellingShingle | Long term condition Medicines adherence Community pharmacy Randomised controlled trial Economic evaluation Markov modelling Elliott, Rachel A. Tanajewski, Lukasz Gkountouras, Georgios Avery, Anthony J. Barber, Nick Mehta, Rajnikant Boyd, Matthew J. Latif, Asam Chuter, Antony Waring, Justin Cost effectiveness of support for people starting a new medication for a long term condition through community pharmacies: an economic evaluation of the New Medicine Service (NMS) compared with normal practice |
| title | Cost effectiveness of support for people starting a new medication for a long term condition through community pharmacies: an economic evaluation of the New Medicine Service (NMS) compared with normal practice |
| title_full | Cost effectiveness of support for people starting a new medication for a long term condition through community pharmacies: an economic evaluation of the New Medicine Service (NMS) compared with normal practice |
| title_fullStr | Cost effectiveness of support for people starting a new medication for a long term condition through community pharmacies: an economic evaluation of the New Medicine Service (NMS) compared with normal practice |
| title_full_unstemmed | Cost effectiveness of support for people starting a new medication for a long term condition through community pharmacies: an economic evaluation of the New Medicine Service (NMS) compared with normal practice |
| title_short | Cost effectiveness of support for people starting a new medication for a long term condition through community pharmacies: an economic evaluation of the New Medicine Service (NMS) compared with normal practice |
| title_sort | cost effectiveness of support for people starting a new medication for a long term condition through community pharmacies: an economic evaluation of the new medicine service (nms) compared with normal practice |
| topic | Long term condition Medicines adherence Community pharmacy Randomised controlled trial Economic evaluation Markov modelling |
| url | https://eprints.nottingham.ac.uk/44314/ https://eprints.nottingham.ac.uk/44314/ https://eprints.nottingham.ac.uk/44314/ |