Understanding the Cost Consequences of Pharmacist Roles in Managing Long-Term Illnesses: A Systematic Review.

Objective: This review looked at how different pharmacist-led services influence medication spending and other economic outcomes for people living with long-term illnesses. Methods: To gather the evidence, we followed the PRISMA 2020 approach and a comprehensive search was conducted using multiple sources, including Web of Science, ProQuest, Scopus, the Directory of Open Access Journals, ScienceDirect, PubMed, and Google Scholar. We included studies that examined pharmacist involvement in medication management such as MTM, medication reconciliation, deprescribing efforts, or full medication reviews and that reported some form of cost or economic outcome in chronic disease care. We left out non-English work, conference abstracts, case reports, and papers without accessible full text. After screening all records, 1420 studies met the inclusion criteria. These ranged from randomized trials to cohort studies, pre-post designs, and a few economic modeling analyses. We evaluated methodological quality using the MMAT (2018), and for the modeling work, we applied the Drummond checklist. Results: Across the different study types, pharmacist involvement generally led to fewer medication-related problems, better adherence, and more appropriate medication use. Several studies showed that these changes translated into lower overall costs for example, through fewer adverse drug events, fewer hospital visits, or by switching patients to more affordable but clinically appropriate therapy options. Some economic evaluations even suggested that these interventions saved more money than they cost. Programs that combined medication review with patient education, deprescribing, and follow-up tended to show the clearest benefits. Conclusion: Taken together, the findings indicate that involving pharmacists more directly in the medication management of individuals with chronic conditions leads to better clinical results and more favorable economic outcomes. These findings support the idea of involving pharmacists more closely within chronic-care teams.