The economic impact of a hybrid pharmacy practice model in patients with metabolic syndrome

Abstract

Objective: The objective of this study is to assess the impact of a hybrid pharmacy practice model of care on (1) economic outcomes and (2) economic outcomes, controlling for adherence level, compared with other community pharmacy models of care in patients with metabolic syndrome. Methods: This is a prospective, randomized controlled study conducted collaboratively between community pharmacy and an accountable care organization. Four hundred twenty-four patients were identified and invited to participate. In August 2014, enrollment began and is ongoing. Patients are required to have type 2 diabetes, hypertension, hyperlipidemia, Paramount insurance, and be prescribed at least five oral medications, with at least one oral medication for each disease state. Patients are randomly assigned to one of four groups receiving different types of care. The first group receives medications in pill bottles with no additional intervention; a second group receives adherence blister packaging with refill synchronization; a third group receives pill bottles and medication therapy management (MTM) through an appointment-based model; and a fourth group receives the hybrid pharmacy practice model, which includes an appointment-based model to provide MTM, adherence packaging, and refill synchronization.comparisons will be made for health care cost and utilization 6 months pre- and post-enrollment. Cost and utilization data regarding outpatient visits, emergency room visits, and hospitalizations will be obtained from medical claims data.comparisons will be made utilizing descriptive and mixed between-within analysis of variance. Additionally, costs and utilization will be compared based on different adherence levels, measured using proportion of days covered acquired from prescription claims. A trend analysis of collected data will be performed. If 6 month data are available at the time of analysis, a two-between one-within mixed methods design will be utilized. Results: Ninety-nine patients have shown interest as potential study subjects and 32 are currently enrolled. Results will be presented at APhA2015.