Pharmacist-led management of chronic pain in primary care: costs and benefits in a pilot randomised controlled trial.
Bottom Line: Differences in mean total costs and effects measured as quality-adjusted life years (QALYs) at 6 months and EVSI for sample size calculation.After controlling for baseline costs, the adjusted mean cost differences per patient relative to TAU were £77 for prescribing (95% CI -82 to 237) and £54 for review (95% CI -103 to 212).Relative to TAU, the adjusted mean differences were 0.0069 for prescribing (95% CI -0.0091 to 0.0229) and 0.0097 for review (95% CI -0.0054 to 0.0248).
Affiliation: Health Economics Research Unit, University of Aberdeen, Aberdeen, UK.Show MeSH
Related in: MedlinePlus
Mentions: The EVSI investigated the cost-effectiveness of carrying out a larger RCT of pharmacist prescribing and pharmacist review versus TAU. The parameters used in the EVSI calculation and the resulting expected EVSI is given in figure 2, which also shows the expected costs of the RCT and the resultant ENG. The expected costs of running the proposed trial rise linearly as the sample size (n) is increased; however, the expected benefits diminish as the sample size increases after a certain point, giving the optimal number of patients in each arm of the RCT. The ‘optimal trial size’ (SS) is estimated as 780 per arm (prescribing vs TAU comparison) and 540 per arm (review vs TAU comparison) using a cost per QALY threshold of £20 000 and 690 per arm (prescribing vs TAU comparison), and 460 per arm (review vs TAU comparison) using a cost per QALY threshold of £30 000.
Affiliation: Health Economics Research Unit, University of Aberdeen, Aberdeen, UK.