No Cover Image

Journal article 339 views 81 downloads

Cost–Effectiveness Analysis of Pharmacist Adherence Interventions in People Living with HIV/AIDS in Pakistan

Ali Ahmed Orcid Logo, Juman Al-Dujaili Orcid Logo, Lay Hong Chuah Orcid Logo, Furqan Khurshid Hashmi, Long Khanh Dao Le Orcid Logo, Zeenat Fatima Chatha, Saval Khanal Orcid Logo, Ahmed Awaisu Orcid Logo, Nathorn Chaiyakunapruk Orcid Logo

Healthcare, Volume: 11, Issue: 17, Start page: 2453

Swansea University Author: Juman Al-Dujaili Orcid Logo

  • 69434.VoR.pdf

    PDF | Version of Record

    © 2023 by the authors. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.

    Download (1.57MB)

Check full text

DOI (Published version): 10.3390/healthcare11172453

Abstract

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 pharm...

Full description

Published in: Healthcare
ISSN: 2227-9032
Published: MDPI AG 2023
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa69434
first_indexed 2025-05-07T16:01:51Z
last_indexed 2025-06-20T04:58:19Z
id cronfa69434
recordtype SURis
fullrecord <?xml version="1.0"?><rfc1807><datestamp>2025-06-19T13:59:47.5035126</datestamp><bib-version>v2</bib-version><id>69434</id><entry>2025-05-07</entry><title>Cost&#x2013;Effectiveness Analysis of Pharmacist Adherence Interventions in People Living with HIV/AIDS in Pakistan</title><swanseaauthors><author><sid>47d192c8bb46dd4c0cc72bbfea4210ec</sid><ORCID>0000-0002-7515-5344</ORCID><firstname>Juman</firstname><surname>Al-Dujaili</surname><name>Juman Al-Dujaili</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2025-05-07</date><deptcode>MEDS</deptcode><abstract>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&#x2013;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&#x2013;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.</abstract><type>Journal Article</type><journal>Healthcare</journal><volume>11</volume><journalNumber>17</journalNumber><paginationStart>2453</paginationStart><paginationEnd/><publisher>MDPI AG</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2227-9032</issnElectronic><keywords>pharmacist; adherence; health outcomes; cost&#x2013;effectiveness; incremental cost&#x2013;effectiveness ratio; Pakistan</keywords><publishedDay>1</publishedDay><publishedMonth>9</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-09-01</publishedDate><doi>10.3390/healthcare11172453</doi><url/><notes/><college>COLLEGE NANME</college><department>Medical School</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>MEDS</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>This research received no external funding.</funders><projectreference/><lastEdited>2025-06-19T13:59:47.5035126</lastEdited><Created>2025-05-07T10:26:42.8648188</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Pharmacy</level></path><authors><author><firstname>Ali</firstname><surname>Ahmed</surname><orcid>0000-0002-8964-1853</orcid><order>1</order></author><author><firstname>Juman</firstname><surname>Al-Dujaili</surname><orcid>0000-0002-7515-5344</orcid><order>2</order></author><author><firstname>Lay Hong</firstname><surname>Chuah</surname><orcid>0000-0001-8283-0849</orcid><order>3</order></author><author><firstname>Furqan Khurshid</firstname><surname>Hashmi</surname><order>4</order></author><author><firstname>Long Khanh Dao</firstname><surname>Le</surname><orcid>0000-0002-9442-6824</orcid><order>5</order></author><author><firstname>Zeenat Fatima</firstname><surname>Chatha</surname><order>6</order></author><author><firstname>Saval</firstname><surname>Khanal</surname><orcid>0000-0001-5201-0612</orcid><order>7</order></author><author><firstname>Ahmed</firstname><surname>Awaisu</surname><orcid>0000-0002-9029-8925</orcid><order>8</order></author><author><firstname>Nathorn</firstname><surname>Chaiyakunapruk</surname><orcid>0000-0003-4572-8794</orcid><order>9</order></author></authors><documents><document><filename>69434__34526__6a63cff4016e4ebe94b2ab0556448840.pdf</filename><originalFilename>69434.VoR.pdf</originalFilename><uploaded>2025-06-19T13:57:41.8340359</uploaded><type>Output</type><contentLength>1642191</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; 2023 by the authors. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>https://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling 2025-06-19T13:59:47.5035126 v2 69434 2025-05-07 Cost–Effectiveness Analysis of Pharmacist Adherence Interventions in People Living with HIV/AIDS in Pakistan 47d192c8bb46dd4c0cc72bbfea4210ec 0000-0002-7515-5344 Juman Al-Dujaili Juman Al-Dujaili true false 2025-05-07 MEDS 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. Journal Article Healthcare 11 17 2453 MDPI AG 2227-9032 pharmacist; adherence; health outcomes; cost–effectiveness; incremental cost–effectiveness ratio; Pakistan 1 9 2023 2023-09-01 10.3390/healthcare11172453 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee This research received no external funding. 2025-06-19T13:59:47.5035126 2025-05-07T10:26:42.8648188 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Pharmacy Ali Ahmed 0000-0002-8964-1853 1 Juman Al-Dujaili 0000-0002-7515-5344 2 Lay Hong Chuah 0000-0001-8283-0849 3 Furqan Khurshid Hashmi 4 Long Khanh Dao Le 0000-0002-9442-6824 5 Zeenat Fatima Chatha 6 Saval Khanal 0000-0001-5201-0612 7 Ahmed Awaisu 0000-0002-9029-8925 8 Nathorn Chaiyakunapruk 0000-0003-4572-8794 9 69434__34526__6a63cff4016e4ebe94b2ab0556448840.pdf 69434.VoR.pdf 2025-06-19T13:57:41.8340359 Output 1642191 application/pdf Version of Record true © 2023 by the authors. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. true eng https://creativecommons.org/licenses/by/4.0/
title Cost–Effectiveness Analysis of Pharmacist Adherence Interventions in People Living with HIV/AIDS in Pakistan
spellingShingle Cost–Effectiveness Analysis of Pharmacist Adherence Interventions in People Living with HIV/AIDS in Pakistan
Juman Al-Dujaili
title_short Cost–Effectiveness Analysis of Pharmacist Adherence Interventions in People Living with HIV/AIDS in Pakistan
title_full Cost–Effectiveness Analysis of Pharmacist Adherence Interventions in People Living with HIV/AIDS in Pakistan
title_fullStr Cost–Effectiveness Analysis of Pharmacist Adherence Interventions in People Living with HIV/AIDS in Pakistan
title_full_unstemmed Cost–Effectiveness Analysis of Pharmacist Adherence Interventions in People Living with HIV/AIDS in Pakistan
title_sort Cost–Effectiveness Analysis of Pharmacist Adherence Interventions in People Living with HIV/AIDS in Pakistan
author_id_str_mv 47d192c8bb46dd4c0cc72bbfea4210ec
author_id_fullname_str_mv 47d192c8bb46dd4c0cc72bbfea4210ec_***_Juman Al-Dujaili
author Juman Al-Dujaili
author2 Ali Ahmed
Juman Al-Dujaili
Lay Hong Chuah
Furqan Khurshid Hashmi
Long Khanh Dao Le
Zeenat Fatima Chatha
Saval Khanal
Ahmed Awaisu
Nathorn Chaiyakunapruk
format Journal article
container_title Healthcare
container_volume 11
container_issue 17
container_start_page 2453
publishDate 2023
institution Swansea University
issn 2227-9032
doi_str_mv 10.3390/healthcare11172453
publisher MDPI AG
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Pharmacy{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Pharmacy
document_store_str 1
active_str 0
description 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.
published_date 2023-09-01T05:28:11Z
_version_ 1851097865489743872
score 11.089386

Similar Items