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VP164 Applying Health Technology Assessment To Pharmacy: The Italian-Medicine-Use-Review-Health Technology Assessment
Published online by Cambridge University Press: 12 January 2018
Abstract
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INTRODUCTION:
There is a lack of Health-Technology-Assessment (HTA) tools in pharmacy practice and the collection of real-world-evidence (RWE) in community pharmacy to populate longer-term-disease-progression-modelling (1). This project is looking at the development and application of a novel Patient-Reported-Outcome- Measure (PROM) in community pharmacy that can enable: the evaluation of the quality of care delivered from the patient perspective in terms of economic impact, patient health outcomes and ‘utilities’; the collection of RWE and evaluate long-term effect of care; to provide different stakeholders with unique evidence-based information that help formulate health policies in community pharmacy that are safe, effective, patient-focused and cost-effective, balancing access to innovation and cost containment.
METHODS:
Evidence from the Italian-Medicine-Use-Review (I-MUR) trial (2) showed that the I-MUR intervention provided by community pharmacists to asthma patients is effective, cost-saving and cost-effective (3). The trial allowed to model a framework (I-MUR-HTA) that would enable to routinely deliver the intervention, but also collect and analyse PROM data on its clinical-effectiveness, quality-of-life and cost-effectiveness. I-MUR-HTA was discussed within three expert-panel discussions including policy-makers, commissioners, academics, healthcare-professionals and patient-representatives in Italy, United Kingdom and Europe. Current plan include testing the use of the tool in the real world environment.
RESULTS:
Evidence collected from the panel discussions confirmed that I-MUR-HTA evidence-based information is relevant to meet current National-Health-Care-System plans and this is what is needed to support the evaluation of innovative effective and cost-effective health policies and promote their implementation across nations. Current Italian law on pharmacy services provides the appropriate institutional framework to regulate the introduction of I-MUR-HTA across the territory. Its implementation is underway and a real-world pilot is planned to take place in Italy.
CONCLUSIONS:
I-MUR-HTA appears to be an innovative tool to promote active patient involvement into policy-decision-making and pharmacy-service.
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References
REFERENCES:
1. Wright, D. 2016. A rapid review of evidence regarding clinical services commissioned from community pharmacies. Commissioned by the Chief Pharmaceutical Officer for England to inform the Murray Review of clinical services in community pharmacy. https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2016/12/rapid-evdnc-rev-dec-16.pdf. Accessed 6 Jan 2017.Google Scholar
2. Manfrin, A, Thomas, T, Krska, J. Randomised evaluation of the Italian medicines use review provided by community pharmacists using asthma as a model (RE I-MUR). BMC Health Serv Res. 2015;15:171. https://doi.org/10.1186/s12913-015-0791-6. Accessed 15 Dec 2015.CrossRefGoogle Scholar
3. Manfrin, A, Tinelli, M, Thomas, T, Krska, J. A cluster randomised control trial to evaluate the effectiveness and cost-effectiveness of the Italian Medicines Use Review (I-MUR) for asthma patients. BMC Health Serv Res. 2017;17: 300; Published online 2017 Apr 24. doi: 10.1186/s12913-017-2245-9CrossRefGoogle ScholarPubMed
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