Patient Outcomes & Healthcare Economics

Question 1

What is the IHI Triple Aim?

Answer 1

1. Improve the patient experience of care
2. Improve the health of populations
3. Reduce, or control per capita cost of care

Question 2

What is the end goal for a pharmacist working for an employer? (Monetary goal)

Answer 2

Make a 3-5x return on investment

Question 3

What is the Asheville Project?

Answer 3

~150 patients
Diabetes Wellness program
Led by COMMUNITY pharmacists
2-3 years long
Improved A1c, blood pressure, LDLs
DECREASED medical claims/visits, INCREASED prescriptions
DECREASED TOTAL CLAIMS
DECREASED SICK TIME
Flaws= 1 group, high dropouts

Question 4

What was the Diabetes 10 City Challenge?

Answer 4

~550 patients
[extension of the Asheville project]
Diabetes wellness program, community RPh led
1 year
Improved clinical outcomes (A1c, LDL, BP, flu vaccines, foot & eye exams)
Medical, Rx and TOTAL claims INCREASED
BUT more decreased costs than expected!

Conclusion: Medical costs rise over time

Question 5

What was the Systematic Review of Pharmacy Economic Evaluations (2023)?

Answer 5

It is what is sounds like (economic evaluation of pharmacy)
Considerable limitations =
- inconsistent study design
- few comparative analyses
- 75 evaluable studies

Evaluated many services (education, counseling, disease screening, vaccination, deprescribing, med rec, discharge, pain management, etc)

Service TYPE dictates amount of return!
HIGH = hospital avoidance, transitions of care, HF services
Low = med adherence, blood pressure services

**Median Benefit-to-Cost ratio = 5:1