Therapy by physician–pharmacist combination and economic returns for cancer pain management in China: a cost-effectiveness analysis
Objective: To examine whether joint management of cancer pain by physicians and pharmacists in clinics provides economic advantages from the perspective of the Chinese healthcare system.Methods: From February 2018 to March 2020, 100 patients who visited the joint cancer pain clinic at the Xiangya Ho...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fphar.2023.1073939/full |
| _version_ | 1797594830109409280 |
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| author | Xikui Lu Xikui Lu Xikui Lu Lu Zhang Lu Zhang Hangxing Huang Hangxing Huang Hangxing Huang Xiangping Wu Xiangping Wu Xiangping Wu Zhenting Wang Zhenting Wang Zhenting Wang Ling Huang Ling Huang Jingyang Li Jingyang Li Huimin Yu Huimin Yu Hongyan Zhang Hongyan Zhang Jian Xiao Jian Xiao |
| author_facet | Xikui Lu Xikui Lu Xikui Lu Lu Zhang Lu Zhang Hangxing Huang Hangxing Huang Hangxing Huang Xiangping Wu Xiangping Wu Xiangping Wu Zhenting Wang Zhenting Wang Zhenting Wang Ling Huang Ling Huang Jingyang Li Jingyang Li Huimin Yu Huimin Yu Hongyan Zhang Hongyan Zhang Jian Xiao Jian Xiao |
| author_sort | Xikui Lu |
| collection | DOAJ |
| description | Objective: To examine whether joint management of cancer pain by physicians and pharmacists in clinics provides economic advantages from the perspective of the Chinese healthcare system.Methods: From February 2018 to March 2020, 100 patients who visited the joint cancer pain clinic at the Xiangya Hospital of Central South University were included. These patients were randomly assigned to either the control or intervention groups. The control group received regular outpatient services from a physician, while the intervention group received regular outpatient services from a physician and medication education provided by a pharmacist. The study considered various direct costs, including drug expenses, physician-pharmacist outpatient services, adverse event management, consultations, examinations, and readmissions. The outcome indicators considered were the cancer pain control rate and the reduction in pain scores. Decision tree modeling, single-factor sensitivity analysis, and probabilistic sensitivity analysis were performed to evaluate the cost-effectiveness of joint physician-pharmacist outpatient services compared to physician-alone outpatient services.Results: The intervention group showed a significantly higher cancer pain control rate than the control group (0.69 vs. 0.39, p = 0.03). In the decision tree model, the intervention group had a significantly lower pain score than the control group (0.23 vs. 0.14). The cost per person in the intervention group was $165.39, while it was $191.1 per person in the control group. The univariate sensitivity analysis showed that the cost of self-management for patients in the control group was identified as the primary sensitivity factor. Probabilistic sensitivity analysis indicated that the joint clinic group had a favorable incremental cost-effectiveness compared to the physician clinic group. In addition, the probabilistic sensitivity analysis demonstrated an absolute advantage in the incremental cost-effectiveness of the joint clinic group over the outpatient physician group.Conclusion: The participation of pharmacists in joint cancer pain clinic services led to improved pain management for patients, demonstrating a clear advantage in terms of cost-effectiveness. |
| first_indexed | 2024-03-11T02:29:13Z |
| format | Article |
| id | doaj.art-e20c1b6e60ae42e4b820e37314b3fce5 |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-03-11T02:29:13Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-e20c1b6e60ae42e4b820e37314b3fce52023-11-18T10:25:30ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122023-08-011410.3389/fphar.2023.10739391073939Therapy by physician–pharmacist combination and economic returns for cancer pain management in China: a cost-effectiveness analysisXikui Lu0Xikui Lu1Xikui Lu2Lu Zhang3Lu Zhang4Hangxing Huang5Hangxing Huang6Hangxing Huang7Xiangping Wu8Xiangping Wu9Xiangping Wu10Zhenting Wang11Zhenting Wang12Zhenting Wang13Ling Huang14Ling Huang15Jingyang Li16Jingyang Li17Huimin Yu18Huimin Yu19Hongyan Zhang20Hongyan Zhang21Jian Xiao22Jian Xiao23Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, ChinaNational Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, ChinaCollege of Pharmacy, Dali University, Dali, ChinaDepartment of Pharmacy, Xiangya Hospital, Central South University, Changsha, ChinaNational Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Pharmacy, Xiangya Hospital, Central South University, Changsha, ChinaNational Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, ChinaCollege of Pharmacy, Dali University, Dali, ChinaDepartment of Pharmacy, Xiangya Hospital, Central South University, Changsha, ChinaNational Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, ChinaCollege of Pharmacy, Dali University, Dali, ChinaDepartment of Pharmacy, Xiangya Hospital, Central South University, Changsha, ChinaNational Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, ChinaCollege of Pharmacy, Dali University, Dali, ChinaDepartment of Pharmacy, Xiangya Hospital, Central South University, Changsha, ChinaNational Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Pharmacy, Xiangya Hospital, Central South University, Changsha, ChinaNational Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Pharmacy, Xiangya Hospital, Central South University, Changsha, ChinaNational Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Pharmacy, Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Pharmacy, Fuwai Central China Cardiovascular Hospital, Zhengzhou, ChinaDepartment of Pharmacy, Xiangya Hospital, Central South University, Changsha, ChinaNational Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, ChinaObjective: To examine whether joint management of cancer pain by physicians and pharmacists in clinics provides economic advantages from the perspective of the Chinese healthcare system.Methods: From February 2018 to March 2020, 100 patients who visited the joint cancer pain clinic at the Xiangya Hospital of Central South University were included. These patients were randomly assigned to either the control or intervention groups. The control group received regular outpatient services from a physician, while the intervention group received regular outpatient services from a physician and medication education provided by a pharmacist. The study considered various direct costs, including drug expenses, physician-pharmacist outpatient services, adverse event management, consultations, examinations, and readmissions. The outcome indicators considered were the cancer pain control rate and the reduction in pain scores. Decision tree modeling, single-factor sensitivity analysis, and probabilistic sensitivity analysis were performed to evaluate the cost-effectiveness of joint physician-pharmacist outpatient services compared to physician-alone outpatient services.Results: The intervention group showed a significantly higher cancer pain control rate than the control group (0.69 vs. 0.39, p = 0.03). In the decision tree model, the intervention group had a significantly lower pain score than the control group (0.23 vs. 0.14). The cost per person in the intervention group was $165.39, while it was $191.1 per person in the control group. The univariate sensitivity analysis showed that the cost of self-management for patients in the control group was identified as the primary sensitivity factor. Probabilistic sensitivity analysis indicated that the joint clinic group had a favorable incremental cost-effectiveness compared to the physician clinic group. In addition, the probabilistic sensitivity analysis demonstrated an absolute advantage in the incremental cost-effectiveness of the joint clinic group over the outpatient physician group.Conclusion: The participation of pharmacists in joint cancer pain clinic services led to improved pain management for patients, demonstrating a clear advantage in terms of cost-effectiveness.https://www.frontiersin.org/articles/10.3389/fphar.2023.1073939/fullcancer painphysician-pharmacistcost-effectiveness analysisdecision treeseconomics |
| spellingShingle | Xikui Lu Xikui Lu Xikui Lu Lu Zhang Lu Zhang Hangxing Huang Hangxing Huang Hangxing Huang Xiangping Wu Xiangping Wu Xiangping Wu Zhenting Wang Zhenting Wang Zhenting Wang Ling Huang Ling Huang Jingyang Li Jingyang Li Huimin Yu Huimin Yu Hongyan Zhang Hongyan Zhang Jian Xiao Jian Xiao Therapy by physician–pharmacist combination and economic returns for cancer pain management in China: a cost-effectiveness analysis Frontiers in Pharmacology cancer pain physician-pharmacist cost-effectiveness analysis decision trees economics |
| title | Therapy by physician–pharmacist combination and economic returns for cancer pain management in China: a cost-effectiveness analysis |
| title_full | Therapy by physician–pharmacist combination and economic returns for cancer pain management in China: a cost-effectiveness analysis |
| title_fullStr | Therapy by physician–pharmacist combination and economic returns for cancer pain management in China: a cost-effectiveness analysis |
| title_full_unstemmed | Therapy by physician–pharmacist combination and economic returns for cancer pain management in China: a cost-effectiveness analysis |
| title_short | Therapy by physician–pharmacist combination and economic returns for cancer pain management in China: a cost-effectiveness analysis |
| title_sort | therapy by physician pharmacist combination and economic returns for cancer pain management in china a cost effectiveness analysis |
| topic | cancer pain physician-pharmacist cost-effectiveness analysis decision trees economics |
| url | https://www.frontiersin.org/articles/10.3389/fphar.2023.1073939/full |
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