Evidence map›Paper›PMID 28776320›Full record

ArticlePharmacoEconomics2017

Cost Effectiveness of Support for People Starting a New Medication for a Long-Term Condition Through Community Pharmacies: An Economic Evaluation of the New Medicine Service (NMS) Compared with Normal Practice.

Rachel A Elliott, Lukasz Tanajewski, Georgios Gkountouras, Anthony J Avery, Nick Barber, Rajnikant Mehta, Matthew J Boyd, Asam Latif, Antony Chuter, Justin Waring

Registry-linked trialOpen access · hybridAbstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in PharmacoEconomics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01635361 (Understanding and Appraising the New Medicine Service in England), which is not on this map. Cited by 21 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 3 pooled it
4.8field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01635361 nacompletednot on this map

Understanding and Appraising the New Medicine Service in England

TypeinterventionalSponsorUniversity of NottinghamRan2012 to 2014Enrolled504ConditionsAsthma, Pulmonary Disease, Chronic Obstructive, Diabetes Mellitus, Type 2, HypertensionArmsNew Medicine Service
3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 62 citations in OpenAlex.

  1. Pooled it
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  12. An Overview of Adherence-What It Is and Why It Is Important.The journal of allergy and clinical immunology. In practice · 2024
    Review
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  17. Beyond price: the effects of non-financial barriers on access to drugs and health outcomes.The European journal of health economics : HEPAC : health economics in prevention and care · 2021
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 1 country.

Rachel A ElliottManchester Centre for Health Economics, Room 4.318, 4th floor, Jean Mcfarlane Building, Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK. Rachel.a.elliott@manchester.ac.uk.ORCID http://orcid.org/0000-0002-3650-0168
Lukasz TanajewskiDivision of Pharmacy Practice and Policy, The School of Pharmacy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK.
Georgios GkountourasDivision of Pharmacy Practice and Policy, The School of Pharmacy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK.
Anthony J AveryPrimary Care Research, Division of Primary Care, School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
Nick BarberEmeritus Professor of Pharmacy, UCL School of Pharmacy, 29-39 Brunswick Square, London, WC1N 1AX, UK.
Rajnikant MehtaResearch Design Service, East Midlands (RDS EM), School of Medicine, Queen's Medical Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
Matthew J BoydDivision of Pharmacy Practice and Policy, The School of Pharmacy, University of Nottingham, University Park, Nottingham, NG7 2RD, UK.
Asam LatifSchool of Health Sciences, Faculty of Medicine and Health Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
Antony ChuterPatient and Public Representative, 68 Brighton Cottages, Copyhold Lane, Lindfield, Haywards Heath, RH16 1XT, UK.
Justin WaringOrganisational Sociology and Improvement Science, Centre for Health Innovation, Leadership and Learning, Nottingham University Business School, Jubilee Campus, University of Nottingham, Nottingham, NG8 2BB, UK.
University of Nottingham · GBHaywards Heath Hospital · GBManchester Academic Health Science Centre · GBMedway School of Pharmacy · GB

Funding

Department of Health ICA-CL-2015-01-008UK Department of Health Policy Research Programme PR-IC-0711-10010
6 · The paper itself

Abstract

backgroundThe English community pharmacy New Medicine Service (NMS) significantly increases patient adherence to medicines, compared with normal practice. We examined the cost effectiveness of NMS compared with normal practice by combining adherence improvement and intervention costs with the effect of increased adherence on patient outcomes and healthcare costs.

methodsWe developed Markov models for diseases targeted by the NMS (hypertension, type 2 diabetes mellitus, chronic obstructive pulmonary disease, asthma and antiplatelet regimens) to assess the impact of patients' non-adherence. Clinical event probability, treatment pathway, resource use and costs were extracted from literature and costing tariffs. Incremental costs and outcomes associated with each disease were incorporated additively into a composite probabilistic model and combined with adherence rates and intervention costs from the trial. Costs per extra quality-adjusted life-year (QALY) were calculated from the perspective of NHS England, using a lifetime horizon.

resultsNMS generated a mean of 0.05 (95% CI 0.00-0.13) more QALYs per patient, at a mean reduced cost of -£144 (95% CI -769 to 73). The NMS dominates normal practice with a probability of 0.78 [incremental cost-effectiveness ratio (ICER) -£3166 per QALY]. NMS has a 96.7% probability of cost effectiveness compared with normal practice at a willingness to pay of £20,000 per QALY. Sensitivity analysis demonstrated that targeting each disease with NMS has a probability over 0.90 of cost effectiveness compared with normal practice at a willingness to pay of £20,000 per QALY.

conclusionsOur study suggests that the NMS increased patient medicine adherence compared with normal practice, which translated into increased health gain at reduced overall cost.

trial registrationClinicalTrials.gov Trial reference number NCT01635361 ( http://clinicaltrials.gov/ct2/show/NCT01635361 ). Current Controlled trials: Trial reference number ISRCTN 23560818 ( http://www.controlled-trials.com/ISRCTN23560818/ ; DOI 10.1186/ISRCTN23560818 ). UK Clinical Research Network (UKCRN) study 12494 ( http://public.ukcrn.org.uk/Search/StudyDetail.aspx?StudyID=12494 ).

fundingDepartment of Health Policy Research Programme.

Indexed as

Health Care CostsMedication AdherenceModels, EconomicAdultAgedCommunity Pharmacy ServicesCost-Benefit AnalysisEnglandFemaleHumansMaleMarkov ChainsMiddle AgedModels, StatisticalQuality-Adjusted Life YearsRandomized Controlled Trials as Topic

Identifiers

PMID28776320
PMCPMC5684280
OpenAlexW2739572121

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.