Cost–effectiveness analysis of pharmacist adherence interventions in people living with HIV/AIDS in Pakistan

Ahmed, Ali, Dujaili, Juman Abdulelah, Chuah, Lay Hong, Hashmi, Furqan Khurshid, Le, Long Khanh Dao, Chatha, Zeenat Fatima, Khanal, Saval ORCID:, Awaisu, Ahmed and Chaiyakunapruk, Nathorn (2023) Cost–effectiveness analysis of pharmacist adherence interventions in people living with HIV/AIDS in Pakistan. Healthcare, 11 (17). ISSN 2227-9032

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Background: Evidence has shown the positive impact of pharmacist involvement on the adherence and health outcomes of people living with HIV/AIDS. However, whether such intervention provides value for money remains unclear. This study aims to fill this gap by assessing the cost–effectiveness of pharmacist interventions in HIV care in Pakistan. Methods: A Markov decision analytic model was constructed, considering clinical inputs, utility data, and cost data obtained from a randomized controlled trial and an HIV cohort of Pakistani origin. The analysis was conducted from a healthcare perspective, and the incremental cost–effectiveness ratio (ICER) was calculated and presented for the year 2023. Additionally, a series of sensitivity analyses were performed to assess the robustness of the results. Results: Pharmacist intervention resulted in higher quality-adjusted life years (4.05 vs. 2.93) and likewise higher annual intervention costs than usual care (1979 USD vs. 429 USD) (532,894 PKR vs. 115,518 PKR). This yielded the ICER of 1383 USD/quality-adjusted life years (QALY) (372,406 PKR/QALY), which is well below the willingness-to-pay threshold of 1658 USD (446,456 PKR/QALY) recommended by the World Health Organization Choosing Interventions that are Cost-Effective. Probabilistic sensitivity analysis reported that more than 68% of iterations were below the lower limit of threshold. Sensitivity analysis reported intervention cost is the most important parameter influencing the ICER the most. Conclusion: The study suggests that involving pharmacists in HIV care could be a cost-effective approach. These findings could help shape healthcare policies and plans, possibly making pharmacist interventions a regular part of care for people with HIV in Pakistan.

Item Type: Article
Uncontrolled Keywords: adherence,cost–effectiveness,health outcomes,incremental cost–effectiveness ratio,pakistan,pharmacist,leadership and management,health policy,health informatics,health information management,sdg 10 - reduced inequalities,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2900/2911
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: LivePure Connector
Date Deposited: 11 Sep 2023 08:30
Last Modified: 24 Oct 2023 01:41
DOI: 10.3390/healthcare11172453

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