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Modeling the Health and Budgetary Impacts of a Team-based Hypertension Care Intervention That Includes Pharmacists
  • Published Date:
    Nov 2019
  • Source:
    Med Care. 57(11):882-889
  • Language:
    English


Public Access Version Available on: November 01, 2020, 12:00 AM information icon
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Details:
  • Alternative Title:
    Med Care
  • Description:
    Objective:

    The objective of this study was to assess the potential health and budgetary impacts of implementing a pharmacist-involved team-based hypertension management model in the United States.

    Research Design:

    In 2017, we evaluated a pharmacist-involved team-based care intervention among 3 targeted groups using a microsimulation model designed to estimate cardiovascular event incidence and associated health care spending in a cross-section of individuals representative of the US population: implementing it among patients with: (1) newly diagnosed hypertension; (2) persistently (≥ 1 year) uncontrolled blood pressure (BP); or (3) treated, yet persistently uncontrolled BP—and report outcomes over 5 and 20 years. We describe the spending thresholds for each intervention strategy to achieve budget neutrality in 5 years from a payer’s perspective.

    Results:

    Offering this intervention could prevent 22.9–36.8 million person-years of uncontrolled BP and 77,200–230,900 heart attacks and strokes in 5 years (83.8–174.8 million and 393,200–922,900 in 20 years, respectively). Health and economic benefits strongly favored groups 2 and 3. Assuming an intervention cost of $525 per enrollee, the intervention generates 5-year budgetary cost-savings only for Medicare among groups 2 and 3. To achieve budget neutrality in 5 years across all groups, intervention costs per person need to be around $35 for Medicaid, $180 for private insurance, and $335 for Medicare enrollees.

    Conclusions:

    Adopting a pharmacist-involved team-based hypertension model could substantially improve BP control and cardiovascular outcomes in the United States. Net cost-savings among groups 2 and 3 make a compelling case for Medicare, but favorable economics may also be possible for private insurers, particularly if innovations could moderately lower the cost of delivering an effective intervention.

  • Pubmed ID:
    31567863
  • Pubmed Central ID:
    PMC6913909
  • Document Type:
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