Economic analysis of introducing a remunerated community - pharmacist consultation service on influenza vaccination for Ontario seniors
Canadian Pharmacists Conference ePoster Library. Pullagura G. 06/03/18; 217826; 28
Gokul Raj Pullagura
Gokul Raj Pullagura
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Objective: In light of poor influenza vaccine uptake, health care provider recommendations continue to remain a frontline strategy in positively influencing patron vaccination decisions. This study aimed to predict the relative quality of life changes, costs and cost-effectiveness of introducing a remunerated community-pharmacist led influenza vaccination consultation service for Ontario seniors in comparison to current standard practices. Methods: A cost-utility analysis (CUA) was performed through decision analytic modeling. The study adopted a third party public payer perspective and a time horizon of one year. The delivery of consultation services by community-pharmacists on influenza vaccine, billable at $15 was compared to current standard practices (absence of a standalone remunerated consultation service). Base-case subjects included those aged ≥65 years accessing community pharmacy services. Data on vaccine safety and efficacy, transition probabilities, costs and utilities were primarily sourced from existing literature. In addition to the base-case analysis, multiple deterministic and probabilistic sensitivity analyses were conducted using decision analysis software, TreeAge® Pro 2017. Results: The incremental costs per quality-adjusted life-year (QALY) gained for the comparator arm relative to the standard arm in the base-case was $993.64. The comparator arm was estimated to prevent 23 additional cases of severe influenza requiring hospitalization and 3,765 cases of mild influenza, not resulting in hospitalization or an out-patient physician visit over the standard arm. The interpretation of the base-case result was found to be robust across all sensitivity analyses. The analysis was mildly sensitive to age and vaccine uptake in the comparator arm. The projected additional costs of implementing pharmacist consultation services were estimated to be $1.47 million/year and the anticipated benefits included a gain of 1,232 QALYs/year over current practices, yielding a net cost of $1,193/QALY gained. Conclusion: Introduction of standalone remunerated consultation services on influenza vaccination by community pharmacists for Ontario seniors offers a cost-effective alternative to current standard practices.
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