Study: Expanded Rx services in Canada could save billions

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OTTAWA — In Canada, the implementation of three pharmacy services could yield cumulative cost savings of $2.5 billion to $25.7 billion over the next 20 years, according to The Conference Board of Canada.

In a new report, the business think tank said changes to pharmacy legislation and standards in the provinces and territories enable community pharmacists to take a bigger role in health care delivery. The potential cost-savings impact of the three services — advanced medication review and management for cardiovascular disease, smoking cessation and pneumococcal vaccination — depends on the level of uptake of these services in the population.

“Pharmacists are an integral part of the health care delivered to many Canadians,” Louis Theriault, vice president of industry strategy and public policy at The Conference Board of Canada, said in a statement. “They could play an even greater role in ensuring the sustainability of the health care system, if we can further capitalize on their expertise as medication experts and expand the services they provide.”

The largest benefits would result from ramping up advanced medication review and management for cardiovascular disease at pharmacies, with cumulative savings estimated at $1.9 billion to $19.3 billion in health care system efficiencies and increased labor productivity by 2035. The “Value of Expanded Pharmacy Services in Canada” report also said pharmacy smoking cessation services could yield savings of $563 million to $5.6 billion, while administering pneumococcal vaccines for people ages 65 and older in pharmacies could produce savings of $206 million to $761 million.

“This report is good news for a cash-strapped health care system, governments, payers and ultimately all Canadians,” stated Alistair Bursey, chairman of the Canadian Pharmacists Association (CPhA). “While we have long understood the health benefits of pharmacist care in interventions such as smoking cessation and cardiovascular disease through past clinical practice research, these findings help to bridge the evidence gap to demonstrate the significant value Canada’s pharmacists can bring to our health care system.”

These three pharmacy services also would yield a large return on investment is also expected for all three community pharmacy services, the report found. By 2035, for every dollar spent, the direct return could reach up to $2.30 for advanced medication review for heart disease, $9.10 for smoking cessation and $72 for pneumococcal vaccination.

Population health benefits from these pharmacy services, The Conference Board of Canada said, include avoiding chronic disease and premature death from the primary prevention of cerebrovascular disease and ischaemic heart disease, averted cases of lung cancer and chronic obstructive pulmonary disease (COPD), secondary prevention of heart attack and stroke, and hospitalized pneumonia.

“With an aging population and increasing budget constraints faced by governments, finding cost-effective and scalable interventions to manage illness and offering preventative measures, such as immunization for vulnerable groups, are important strategies to help ensure the financial viability of the health care system and the strength of the Canadian economy,” Theriault added.

A second report, “Getting the Most Out of Community Pharmacy: Recommendations for Action”, addresses the policy, practice, and research challenges involved with the expansion of pharmacy services in Canada.

“If given the opportunity, community pharmacists could do more to help meet the growing demand for convenient, accessible, and cost-effective health care services,” CPhA’s Bursey commented. “The infrastructure for these services already exists. Now we must expand pharmacists’ scope of practice and remunerate them appropriately to provide this care across the country.”


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