COST-EFFECTIVENESS OF RESPIRATORY MEDICATION THERAPY ADHERENCE CLINIC (RMTAC) AMONG GOVERNMENT HEALTH CLINICS IN KUALA LUMPUR & PUTRAJAYA
In Malaysia, pharmacist-managed RMTAC has been introduced to effectively control patient's asthma.
This study aimed to evaluate cost-effectiveness of RMTAC versus standard pharmaceutical services in improving asthma control in government health clinics setting.
A multicenter quasi-experimental study was conducted in 16 health clinics in Kuala Lumpur and Putrajaya. Subjects were recruited and divided into two groups, intervention for those from 10 clinics which provide RMTAC services, while the other 6 clinics served as control and patients received conventional counselling. Then, patients were followed up for 6 months to assess asthma control, inhalation technique and frequency of exacerbation. Cost effectiveness analysis was conducted from the perspective of health care provider, which is the Ministry of Health Malaysia.
321 patients were recruited, RMTAC significantly improved asthma control which 51.9% of subjects were well controlled after 6-months intervention compared to 20.9% in standard care group (p<0.001). Majority RMTAC patients also mastered good Inhalation technique (75.3%), which is significantly higher than standard care patients (31.9%) (p<0.001). RMTAC is cost-effective; the incremental cost-effectiveness ratio (ICER) is MYR139.04 per patient achieving well asthma control. The sensitivity analysis demonstrated that the baseline result is robust.
In conclusion, RMTAC is beneficial and cost-effective in asthma management.