The cost effectiveness of a pharmacist reviewing medication among the elderly in the community

Aims: The study aims to assess the cost effectiveness of medication review and advice by a consultant pharmacist to elderly people living in the community in Australia. Method: The quality of life and cost of health and social services for a cohort of elderly patients seen by an aged care assessment team (ACAT) was measured at initial referral and at one month follow up. Sites in Melbourne and Ballarat were chosen and analysed separately. A second subsequent cohort was assessed by a team, which included a pharmacist who provided advice to the team and the patient's GP. Quality of life was measured using the SF-36 and the AQoL. Results: Patients seen by an ACAT had a quality of life considerably below full health. Overall there was no significant change in quality of life in either group by either measure. The additional cost of the pharmacist was less than $77 per patient. Compared to no intervention, there was some evidence of an increase in the cost of prescription pharmaceuticals, and a reduction in home care assistance and medical care costs in Melbourne but not in Ballarat. Cost data were highly skewed however, making statistical tests of cost differences problematic. The addition of a pharmacist may be cost reducing in some settings especially if inpatient episodes for assessment and treatment can be avoided, but the study was not able to demonstrate a statistically significant reduction in overall costs associated with pharmacist review and advice.