A pharmacy-based health promotion programme in hypertension: cost-benefit analysis.

OBJECTIVE To weigh the costs and benefits of a pharmacy-based health promotion programme implemented in four pharmacies of the Quebec City area, Canada. This programme was developed to improve blood pressure control through activities aimed at improving the quality of prescribing and the adherence to treatment. DESIGN Nine pharmacies in Quebec City were included, of which four pharmacies were assigned to the implementation of the health promotion programme. Each time a study participant came to one of these pharmacies to refill his/her antihypertensive medication, the pharmacist would measure and record the participant's blood pressure and assess adherence to drug treatment. The other five pharmacies delivered usual care. The duration of the intervention programme was 9 months. Costs included direct, indirect, and fixed costs, and the costs of pharmacist intervention. Benefits were measured using cost savings induced by pharmacist intervention. Willingness to pay was also considered. A bootstrap method was used to test the between-group difference. PERSPECTIVE The study was performed from a societal perspective. STUDY PARTICIPANTS 100 individuals aged between 34 and 80 years residing in the Quebec City area and taking antihypertensive medication. MAIN OUTCOME MEASURES AND RESULTS Participants exposed to the programme had a significant decrease in mean direct costs and a significant increase in mean indirect costs compared with non-exposed participants. Pharmacist interventions involved a mean cost of 30.68 Canadian dollars ($ Can) per participant exposed to the programme. On average, exposed participants were willing to pay $ Can 0.54 per month after the intervention period. Benefits were about ten times higher than costs (1998 values). CONCLUSIONS The implementation of this intervention programme seems promising in the quest to improve blood pressure control in terms of both costs and benefits.