Cost-effectiveness of pharmacist intervention in oral antidiabetic treated and insulin treated type 2 diabetes mellitus

Abstract

Background: Type 2 diabetes mellitus (T2DM) is a significant global health issue and projected to affect around 643 million people by 2030. Objectives: This study analyzed the cost-effectiveness of pharmacist intervention in oral antidiabetic-treated and insulin-treated T2DM outpatients admitted to the University of Sumatera Utara (USU) Hospital, Medan, Indonesia. Methods: This pre and post quasi-experimental economic study analyzed the cost-effectiveness of pharmacist intervention in oral antidiabetic-treated and insulin-treated T2DM outpatients (n=106) admitted to USU Hospital based on payer perspective, period from April to July 2023. Baseline data for one-month treatment were assessed before pharmacist intervention. The pharmacist intervention was provided monthly for the following 3 months. The materials provided in the pharmacist intervention consisted of T2DM educational brochures and patient counseling. The clinical outcome measured pre and post pharmacist intervention was the proportion (%) of the patients with controlled glycated haemoglobin (HbA1c). Monthly direct medical costs before and after intervention were extracted from these patients’ medical records. Cost-effectiveness ratios (CER) and incremental cost-effectiveness ratios (ICERs) for the oral antidiabetic and insulin therapies provided to these patients were analyzed. In this study, one-way sensitivity analysis and WHO threshold were also performed. Appropriate statistical analyses were also applied in this study. Results: Most (54.71%) of the T2DM patients were female. Their mean age was 58.61 ± 8.89 years. Of the 106 patients, 48 and 58 patients received oral antidiabetics and insulin therapies, respectively. CER (USD) for oral antidiabetic-treated patients: before pharmacist intervention, 39.67; after pharmacist intervention, 30.76. CER (USD) for insulin-treated patients: before pharmacist intervention, 1,326.78; after pharmacist intervention, 206.99. ICERs (USD) for: oral antidiabetic-treated patients, 2.7471; insulin-treated patients,-86.1376. Conclusion: Management of oral antidiabetic-treated and insulin-treated T2DM patients with pharmacist intervention was more cost-effective compared to that of standard treatment.