Abstract
Introduction: Automated medication systems have been found to reduce errors in the medication process, but little is known about the cost-effectiveness of such systems. The objective of this study was to perform a model-based indirect cost-effectiveness comparison of three different, real-world automated medication systems compared with current standard practice. Methods: The considered automated medication systems were a patient-specific automated medication system (psAMS), a non-patient-specific automated medication system (npsAMS), and a complex automated medication system (cAMS). The economic evaluation used original effect and cost data from prospective, controlled, before-and-after studies of medication systems implemented at a Danish hematological ward and an acute medical unit. Effectiveness was described as the proportion of clinical and procedural error opportunities that were associated with one or more errors. An error was defined as a deviation from the electronic prescription, from standard hospital policy, or from written procedures. The cost assessment was based on 6-month standardization of observed cost data. The model-based comparative cost-effectiveness analyses were conducted with system-specific assumptions of the effect size and costs in scenarios with consumptions of 15,000, 30,000, and 45,000 doses per 6-month period. Results: With 30,000 doses the cost-effectiveness model showed that the cost-effectiveness ratio expressed as the cost per avoided clinical error was €24 for the psAMS, €26 for the npsAMS, and €386 for the cAMS. Comparison of the cost-effectiveness of the three systems in relation to different valuations of an avoided error showed that the psAMS was the most cost-effective system regardless of error type or valuation. Conclusion: The model-based indirect comparison against the conventional practice showed that psAMS and npsAMS were more cost-effective than the cAMS alternative, and that psAMS was more cost-effective than npsAMS.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Applied Health Economics and Health Policy |
| Vol/bind | 16 |
| Udgave nummer | 1 |
| Sider (fra-til) | 91-106 |
| Antal sider | 16 |
| ISSN | 1175-5652 |
| DOI | |
| Status | Udgivet - 1 feb. 2018 |
| Udgivet eksternt | Ja |
Bibliografisk note
Funding Information:This study could not have been performed without the intensive work of the project group, which included both clinical and hospital pharmaceutical staff, who were active in the planning and implementation of the intervention. We thank the pharmaceutical staff who participated in the data collection and the supervisory group within the Hospital Pharmacy who followed and supported the study. Thanks also to the Steering Committee for their support for the study and assistance in communicating the results to a wider audience. We thank Sharon Preece for comments and language editing of the manuscript. The data collection for this study was registered and approved by the Danish Data Protection Agency (journal no. 1-16-02-163-12). According to Danish law, this study did not require ethical approval from the National Committee on Health Research Ethics. This is a part of BWR’s PhD program. The study was financially supported by the Research and Development Fund”, which is administered by the pharmaceutical procurement service for the five regional authorities in Denmark (AMGROS). The project ID is U-0034. Bettina W. Risør, Marianne Lisby, and Jan Sørensen declare that they have no conflicts of interest.
Publisher Copyright:
© 2017, Springer International Publishing AG.