Pharmacist Care for Patients with Hypertension Would Save NL Health Care System $335 million
First study of its kind highlights significant economic impact of pharmacist care in hypertension management
April 27, 2017 (St. John’s, NL) A new study shows that comprehensive long-term pharmacist care, including patient education and prescribing for Newfoundland and Labrador residents with hypertension, not only improves health outcomes but will save money for the province’s cash-strapped health care system. Among the 114,000 residents with hypertension, in about 40 per cent (or 45,000 people), their hypertension is not well controlled. If full scope pharmacist care were administered to even half of these patients whose hypertension is not adequately controlled, projected cost savings would be more than $335 million over 30 years.
The study looked at whether long-term pharmacist care would decrease events of cardiovascular and kidney disease, what magnitude of differences in survival and quality of life could be achieved, what the effect on direct medical costs would be, and how cost effective the intervention could be.
“For the first time there is evidence illustrating the significant amount of health care dollars that can be saved by allowing pharmacists to provide full scope of care to Newfoundlanders and Labradorians living with hypertension,” said Carlo Marra, lead researcher of the study. “While there has long been evidence available for the health benefits of pharmacist care in hypertension management, there has been, until now, a lack of research done on the economic value of this type of care, particularly in Canada.”
In all analyses, the rates for cardiovascular disease and kidney failure are lowest with the full scope of pharmacist care and highest under the usual care regime. The results also highlight the relatively low costs of the program, particularly relative to the costs of treating cardiovascular disease or kidney failure.
“With the large number of people living with hypertension in Newfoundland and Labrador, the burden on society is enormous both in health and economic terms. Pharmacists are highly accessible primary health care providers and ideally positioned to address the care gap in hypertension management,” said Steve Gillingham, President of the Pharmacists’ Association of Newfoundland and Labrador. “With the infrastructure for these services already in place, we need to ensure our pharmacists are able to make use of their full scope of skills, improving outcomes in patients and, as a result, creating savings for the public purse.”
Previous research has shown that systolic blood pressure would be reduced by 18.3 mmHg with full scope pharmacist care. When applied to this study, over 30 years, it is estimated that for every five people receiving full scope pharmacist care, one cardiovascular event (defined as stroke, heart attack, angina and heart failure) would be avoided and four years of life would be saved.
When even half of the patients with hypertension that is not well controlled are considered over 30 years of full scope care, there would be:
- 2851 fewer strokes
- 5645 fewer heart attacks
- 1630 fewer cases of angina
- 1494 fewer instance of heart failure
- 39 fewer instances kidney failure
- An additional 20,000 years lived
The peer-reviewed study, Cost-effectiveness of pharmacist care for managing hypertension in Canada, appears in the Canadian Pharmacists Journal and was authored by Carlo Marra, PharmD, PhD; Karissa Johnston, MSc, PhD; Valerie Santschi, PharmD, PhD; and Ross T. Tsuyuki, BSc(Pharm), PharmD,MSc, FCSHP, FACC.
- Improving Health and Lowering Costs: Benefits of pharmacist care in hypertension in Newfoundland and Labrador
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PANL is the voice of pharmacists, with membership including over 700 pharmacists, 160 pharmacy students and 150 pharmacies. PANL advocates for pharmacists as health care team members integral to the effective and efficient delivery of health services in Newfoundland and Labrador.