Community pharmacists deliver cheaper, quality care for minor ailments, study shows

By Pooja Toshniwal PahariaReviewed by Benedette Cuffari, M.Sc.Jun 2 2024

In a recent study published in the journal ClinicoEconomics and Outcomes Research, researchers compared minor ailments care provided by community pharmacists to that provided by primary care physicians (PCP), urgent care facilities, and emergency departments (ED).

Study: Expanding Access to Patient Care in Community Pharmacies for Minor Illnesses in Washington State. Image Credit: PeopleImages.com - Yuri A / Shutterstock.com

Expandingpharmacist'sist’s role

As demand for healthcare services in the United States continues to surpass capacity, new distribution methods are urgently needed. One approach involves using non-physician practitioners to reduce high wait times and cost difficulties for low-income patients.

Diversification of responsibilities and workforce development can help improve population healthcare efficiency. Pharmacists, for example, have progressed from medicine dispensing to pharmaceutical therapy management and other healthcare services. In fact, many pharmacists have been successfully integrated with healthcare teams to enhance patient outcomes and develop novel healthcare delivery models.

About the study

The present study examines care costs and quality disparities between pharmacist-provided treatment and standard care from PCPs, urgent care clinics, and ED facilities.

Between 2016 and 2019, pharmacy site visits were conducted at 46 pharmacies, which comprised 175 pharmacists across five pharmacy businesses. The study included community pharmacies such as drugstores, grocery shops, multi-departments, and skilled pharmacists who provided patient healthcare services like vaccines and point-of-care testing.

The researchers used revisit data to determine whether pharmacist-provided care improved access quality and reduced financial strain on the healthcare system. Revisit data from pharmaceutical claims was acquired through 30-day follow-up phone calls. A large healthcare plan in Washington identified non-pharmacy venues of care by connecting episodes of care to ailments reported in community pharmacies.

Data on the viability of providing services in community pharmacy settings was gathered and included training, supplies, space needs, paperwork, workflow, and adherence to prescriptive authority restrictions. Health plan episodes and claim lines data were used to obtain cost and visit information for conventional or non-pharmacy care settings.

Healthcare costs for patient visits were calculated based on the patient-reported treatment site and median expense using standard site-of-care data. Superiority and non-inferiority trial designs were utilized for cost-of-care and revisit data analyses.

The cost-of-care study included data and mean expenditures for initial care at all treatment sites and subsequent care required for those care episodes. Quality assessment examined patient revisit information to determine whether community pharmacists eased the conventional healthcare system's access load. The cost for each condition and pharmacy firm, which became patients' out-of-pocket expenses, was also determined.

Patients younger than 18 years of age were excluded from the analysis.

Study findings

The overall number of patients included in the health plan data for comparison for all diseases was 84,555, with hormonal contraception, asthma, urinary tract infections (UTIs), allergies, and headaches ranking first through fifth. For each disease indicated, the healthcare cost was much lower when delivered by a community pharmacist as compared to conventional healthcare locations. More specifically, the median healthcare cost across traditional places of care was $278 higher than care delivered by pharmacies.

Return treatment was non-inferior to conventional settings in initial visit handling by pharmacists. In order of highest to lowest difference in cost of care between traditional locations and community pharmacies, EDs, urgent care, and PCPs cost $505, $123, and $96, respectively. A further examination of the median cost of care differential by ailment revealed that asthma, UTI, and yeast infection have the highest median cost difference.

If 496 pharmacy care recipients sought treatment at conventional care centers, the estimated additional expense to healthcare systems would have been $138,000. Comparatively, if 84,555 traditional care recipients had visited community pharmacies, healthcare cost savings would have been $23,500,000.

Women were more likely to visit community pharmacies for hormonal contraception and UTIs, with cost differences being the smallest for hormonal contraception and the second largest for UTIs. This finding indicates that community pharmacists can potentially save healthcare costs.

Conclusions

Community pharmacist-provided treatment for minor sicknesses increased healthcare access while reducing the financial burden on the healthcare system. This strategy is accepted widely and successfully expands healthcare access to rural and neglected regions; however, specific states may be unable to access care due to systemic constraints and out-of-pocket expenses.

Expanding clinical treatment options to easily reachable community-based venues may improve healthcare sustainability while reducing expenses for patients and population health initiatives. Pharmacy education programs may also expand healthcare access by offering comprehensive education for enhanced patient care and clinical decision-making.