Cost-utility analysis of a consensus and evidence-based medication review to optimize and potentially reduce psychotropic drug prescription in institutionalized dementia patients
Abstract Background Growing evidence shows the effects of psychotropic drugs on the evolution of dementia. Until now, only a few studies have evaluated the cost-effectiveness of psychotropic drugs in institutionalized dementia patients. This study aims to assess the cost-utility of intervention perf...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-05-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-021-02287-7 |
| _version_ | 1819096471271636992 |
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| author | Mireia Massot Mesquida Frans Folkvord Gemma Seda Francisco Lupiáñez-Villanueva Pere Torán Monserrat |
| author_facet | Mireia Massot Mesquida Frans Folkvord Gemma Seda Francisco Lupiáñez-Villanueva Pere Torán Monserrat |
| author_sort | Mireia Massot Mesquida |
| collection | DOAJ |
| description | Abstract Background Growing evidence shows the effects of psychotropic drugs on the evolution of dementia. Until now, only a few studies have evaluated the cost-effectiveness of psychotropic drugs in institutionalized dementia patients. This study aims to assess the cost-utility of intervention performed in the metropolitan area of Barcelona (Spain) (MN) based on consensus between specialized caregivers involved in the management of dementia patients for optimizing and potentially reducing the prescription of inappropriate psychotropic drugs in this population. This analysis was conducted using the Monitoring and Assessment Framework for the European Innovation Partnership on Active and Healthy Ageing (MAFEIP) tool. Methods The MAFEIP tool builds up from a variety of surrogate endpoints commonly used across different studies in order to estimate health and economic outcomes in terms of incremental changes in quality adjusted life years (QALYs), as well as health and social care utilization. Cost estimates are based on scientific literature and expert opinion; they are direct costs and include medical visits, hospital care, medical tests and exams and drugs administered, among other concepts. The healthcare costs of patients using the intervention were calculated by means of a medication review that compared patients’ drug-related costs before, during and after the use of the intervention conducted in MN between 2012 and 2014. The cost-utility analysis was performed from the perspective of a health care system with a time horizon of 12 months. Results The tool calculated the incremental cost-effectiveness ratio (ICER) of the intervention, revealing it to be dominant, or rather, better (more effective) and cheaper than the current (standard) care. The ICER of the intervention was in the lower right quadrant, making it an intervention that is always accepted even with the lowest given Willingness to Pay (WTP) threshold value (€15,000). Conclusions The results of this study show that the intervention was dominant, or rather, better (more effective) and cheaper than the current (standard) care. This dominant intervention is therefore recommended to interested investors for systematic application. |
| first_indexed | 2024-12-21T23:59:43Z |
| format | Article |
| id | doaj.art-1fd0473a6884445a96d1d53bf2d5047a |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-21T23:59:43Z |
| publishDate | 2021-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-1fd0473a6884445a96d1d53bf2d5047a2022-12-21T18:45:44ZengBMCBMC Geriatrics1471-23182021-05-0121111210.1186/s12877-021-02287-7Cost-utility analysis of a consensus and evidence-based medication review to optimize and potentially reduce psychotropic drug prescription in institutionalized dementia patientsMireia Massot Mesquida0Frans Folkvord1Gemma Seda2Francisco Lupiáñez-Villanueva3Pere Torán Monserrat4Servei d’Atenció Primària Vallès Occidental, Direcció d’Atenció Primària Metropolitana Nord. Institut Català de la Salut. SabadellTilburg School of Humanities and Digital Sciences, Tilburg UniversityGrup de Recerca Multidisciplinar en Salut i Societat (GREMSAS), accredited by AGAUR (2017 SGR 917)Open Evidence Research, Universitat Oberta de CatalunyaGrup de Recerca Multidisciplinar en Salut i Societat (GREMSAS), accredited by AGAUR (2017 SGR 917)Abstract Background Growing evidence shows the effects of psychotropic drugs on the evolution of dementia. Until now, only a few studies have evaluated the cost-effectiveness of psychotropic drugs in institutionalized dementia patients. This study aims to assess the cost-utility of intervention performed in the metropolitan area of Barcelona (Spain) (MN) based on consensus between specialized caregivers involved in the management of dementia patients for optimizing and potentially reducing the prescription of inappropriate psychotropic drugs in this population. This analysis was conducted using the Monitoring and Assessment Framework for the European Innovation Partnership on Active and Healthy Ageing (MAFEIP) tool. Methods The MAFEIP tool builds up from a variety of surrogate endpoints commonly used across different studies in order to estimate health and economic outcomes in terms of incremental changes in quality adjusted life years (QALYs), as well as health and social care utilization. Cost estimates are based on scientific literature and expert opinion; they are direct costs and include medical visits, hospital care, medical tests and exams and drugs administered, among other concepts. The healthcare costs of patients using the intervention were calculated by means of a medication review that compared patients’ drug-related costs before, during and after the use of the intervention conducted in MN between 2012 and 2014. The cost-utility analysis was performed from the perspective of a health care system with a time horizon of 12 months. Results The tool calculated the incremental cost-effectiveness ratio (ICER) of the intervention, revealing it to be dominant, or rather, better (more effective) and cheaper than the current (standard) care. The ICER of the intervention was in the lower right quadrant, making it an intervention that is always accepted even with the lowest given Willingness to Pay (WTP) threshold value (€15,000). Conclusions The results of this study show that the intervention was dominant, or rather, better (more effective) and cheaper than the current (standard) care. This dominant intervention is therefore recommended to interested investors for systematic application.https://doi.org/10.1186/s12877-021-02287-7Cost-benefit analysisPatient-centered medication reviewDementiaPsychotropic drugsNursing homesInstitutionalized patients |
| spellingShingle | Mireia Massot Mesquida Frans Folkvord Gemma Seda Francisco Lupiáñez-Villanueva Pere Torán Monserrat Cost-utility analysis of a consensus and evidence-based medication review to optimize and potentially reduce psychotropic drug prescription in institutionalized dementia patients BMC Geriatrics Cost-benefit analysis Patient-centered medication review Dementia Psychotropic drugs Nursing homes Institutionalized patients |
| title | Cost-utility analysis of a consensus and evidence-based medication review to optimize and potentially reduce psychotropic drug prescription in institutionalized dementia patients |
| title_full | Cost-utility analysis of a consensus and evidence-based medication review to optimize and potentially reduce psychotropic drug prescription in institutionalized dementia patients |
| title_fullStr | Cost-utility analysis of a consensus and evidence-based medication review to optimize and potentially reduce psychotropic drug prescription in institutionalized dementia patients |
| title_full_unstemmed | Cost-utility analysis of a consensus and evidence-based medication review to optimize and potentially reduce psychotropic drug prescription in institutionalized dementia patients |
| title_short | Cost-utility analysis of a consensus and evidence-based medication review to optimize and potentially reduce psychotropic drug prescription in institutionalized dementia patients |
| title_sort | cost utility analysis of a consensus and evidence based medication review to optimize and potentially reduce psychotropic drug prescription in institutionalized dementia patients |
| topic | Cost-benefit analysis Patient-centered medication review Dementia Psychotropic drugs Nursing homes Institutionalized patients |
| url | https://doi.org/10.1186/s12877-021-02287-7 |
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