1. Value of Pharmacy Services January 31 st (A), 2011 J. Hirsch, Ph.D. SSPPS – 207 Introduction to Health Care Systems and Policy

2. Value of Pharmacy Services What does the record show? Outcomes Clinical Economic Quality of Life

6. ETC…. Therapeutic Outcomes

7. Safety Outcomes

8. Humanistic Outcomes

9. Jadad Score: Indicates potential for bias in study design 1-5 (most to least bias potential); higher score better.

13. Summary Results Favorable results (vs. comparative services group) Therapeutic and Safety outcomes (p<0.05) HbA1c LDL cholesterol Blood pressure Adverse drug events Humanistic outcomes – more variability – yet SOME favorable (p<0.05) Medication adherence Patient knowledge Quality of Life – not so much…..

14. On WebCT under readings – but not a required reading. Only content (general results) relevant for Concept Quiz.

18. Summary Economic Effects Pharmacists Most economic studies were flawed e.g. partial cost analyses, weak study design 126 met criteria for review 15.9% (n=20) positive results 42.1% (n=53) mixed results 4.8% (n=6) no effect 37.3% (n=47) unclear effect Positive studies mostly involved technical or multi-model interventions

21. Economic Evaluations of Clinical Pharmacy Services: 2001-2005 Perez et.al., Pharmacotherapy 2008;28:286e-323e Economic Outcomes

22. Economic Evaluations of Clinical Pharmacy Services: 2001-2005 Literature Review Update to previous ACCP review Focused on Economic Outcomes Excluded any with only clinical and humanistic outcomes Results 3,793 articles & abstracts 93 in final group, 15 in B/C

23. Settings of Economic Evaluations of Clinical Pharmacy Services

24. Type of Service or Intervention

25. Benefit:Cost Ratios

26. “Based on the evidence examined in this review, clinical pharmacy services continue to provide a significant return on investment, but improvements are still needed in the methods used to evaluate the economic impact of these services.” Conclusion