Four of the UK’s largest pharmacy chains have designed a pharmacy care plan to support people with multiple long-term conditions which they claim can reduce healthcare costs by as much as 21%.
The Community Pharmacy Future (CPF) group which comprises Boots UK, LloydsPharmacy, Rowlands Pharmacy and Well Pharmacy rolled the plan out to 378 patients in west Yorkshire over a 12-month period through 38 community pharmacies including independents and supermarket pharmacies.
The knowledge, skill and confidence of individuals with long-term conditions to manage their own health and care was assessed using a patient activation measure (PAM). Each patient was scored at different activation levels and supported to move up a level, with researchers concluding that “by moving from the lowest activation level to the highest, healthcare costs can be reduced by up to 21%.”
The CPF said: “The evaluation showed that overall statistically significant increases in levels of patient activation, self-reported adherence to their medication and self-reported quality of life were achieved. The health economic analysis results suggest that the service can be considered to be cost effective.”
The project, which was carried out alongside academics from the University of East Anglia, revealed that patients can be empowered to manage their own conditions through regular discussions with community pharmacists.
“These include tailored coaching, signposting, and self-management guidance aimed at increasing patients’ levels of activation,” the CPF said.
During the project 93% of patients who attended the first appointment agreed one or more health goals with the pharmacist and 39.3% of patients who set goals achieved one or more of those.
The CPF also reported a “significant improvement” in patient activation scores, systolic and diastolic blood pressure, adherence and quality of life.
The CPF added: “In the UK, NICE (National Institute for Health and Care Excellence) refers to a cost effectiveness threshold value of £20-30k per QALY with an ICER (incremental cost-effectiveness ratio) of below £20k being considered value for money. The ICER was estimated to be £8,495 per QALY suggesting that PCP service is a cost-effective solution for the NHS.”
Clare Kerr, head of healthcare policy and strategy for Celesio UK, said: “The design, delivery and evaluation of this service has grown the ever-increasing evidence base for the value of community pharmacy, which was one of the key goals for this project.
“Either the full-service package, or elements of it, can easily be integrated into wider primary care models, supporting patients with multiple long-term conditions to become more activated and better able to self-care, improving their potential outcomes and reducing the cost of their care to the system.”
Jane Devenish, NHS standards and services pharmacist at Well, said: “With the NHS under unprecedented pressure to transform, community pharmacy care plans must become part of the integrated package of care commissioned by the NHS so that each patient gets appropriate support to reach their health goals.”
Rowlands’ managing director Kenny Black said: “The research has identified that (pharmacy care plans) can reduce healthcare costs by up to 21% which is an impressive outcome which should attract the interest of the Department of Health and (NHS England).
“Research such as this provides community pharmacy with important evidence we can take to politicians and policy makers and say support us to unlock our potential and we can deliver improved patient outcomes at lower cost to the NHS.
“It reinforces the evidence base for a service-based contract and provides the PSNC and others with the ammunition they need in the negotiations which lie ahead.”