Paying for community pharmacy-based medication reviews for Type 2 Diabetes : A feasibility and budget impact analysis

Abstract

Background: The medication treatment of type 2 diabetes often requires polypharmacy which is associated with an increased risk for adverse drug events. Medication reviews aim to identify drug-related problems and have been implemented in various countries as a reimbursed service provided by pharmacists. In Germany, recent political arbitrations have boosted the discussion regarding the reimbursement of pharmaceutical services and medication reviews, but as of today, no decision has been made. Accordingly, it is necessary to analyse the financial feasibility of reimbursing medication reviews for the statutory health insurance as the main budget holder. Objective: To estimate the financial implications when reimbursing medication reviews for people with type 2 diabetes and to identify a feasible remuneration rate as well as requirements for the reimbursement of community-pharmacy based medication reviews. Methodology: In a business impact analysis, the financial consequences of the reimbursement of medication reviews for people with type 2 diabetes have been illustrated for a five-year period to identify financially feasible scenarios and remuneration rates. In two expert interviews requirements for the reimbursement of medication reviews have been identified. Results: The reimbursement of medication reviews can be feasible in some scenarios but depends on the set remuneration rate, size of the population and the chosen acceptance threshold. Identified requirements include documentation, educational training, use of digitalized tools, and knowledge databases. In the future, there is the need for evidence-based patient-related outcomes. Conclusion: Medication reviews for people with type 2 diabetes can be financially feasible for statutory health insurance. There is the need for more clarity regarding the general conditions for providing pharmaceutical services in Germany and more research is needed to be able to analyse the cost-effectiveness of this intervention.