Supporting Innovation in Pharmacy for a Healthier Canada

Cost-effectiveness of UTI prescribing attracts attention


UTI_analysis

FEBRUARY 2020 - An economic analysis proving the cost-effectiveness of pharmacists managing uncomplicated urinary tract infections (UTIs) is garnering interest among Canada and abroad.

The report, released last July, assessed the budget impact and cost-effectiveness related to the findings of the RxOUTMAP study, funded in part by the Canadian Foundation for Pharmacy. That study showed that pharmacists can safely manage UTIs, resulting in high clinical cure rates and patient satisfaction.

“The economic analysis is an important part of the puzzle and we’ve been very encouraged by the feedback we’ve received to date,” says Joelle Walker, Vice-President, Public Affairs at the Canadian Pharmacists Association. “While it’s premature to determine the impact of the study, armed with such evidence the profession has a strong case to present to provincial governments.”

The economic study establishes that there is a compelling case for UTI prescribing by pharmacists, in light of the anticipated cost savings. “We’re pleased that several provincial pharmacy associations have already provided the findings to their governments,” says Walker. “If we want to ensure that pharmacists across Canada are practising to their full scope—with the appropriate reimbursement in place—we need to continue to build the case with evidence like this to illustrate just how underutilized the profession is.”

In Alberta, pharmacists have had the ability to prescribe all Schedule 1 medications, including antibiotics, since 2007 and have been able to order lab tests since 2010. Funding to support assessment for prescribing has been in place since 2012. “This research simply affirms that Alberta should no longer be the only province with pharmacists able to offer this level of quality healthcare service, but should be joined by other provinces so that they too have the potential to realize these types of health-system savings," says Margaret Wing, CEO of the Alberta Pharmacists’ Association (RxA). "We see evidence of similar economic benefits to health systems expenditures from pharmacists' management of hypertension as well, and believe there are similar opportunities to demonstrate value for pharmacists managing other conditions such as diabetes, asthma, COPD, the list goes on."

Other countries are also using this Canadian research to push for reimbursement for services among their own pharmacists. “The RxOUTMAP study…has been the key compelling reference point for the Pharmacy Guild in Australia in our advocacy across Australian jurisdictions to allow pharmacists to practise to our full scope,” says George Tambassis, the Guild’s National President. “We are indebted to [study lead] Dr Ross Tsuyuki and his colleagues for their ground-breaking work.”

Tambassis points to a trial soon underway in the State of Queensland where appropriately trained pharmacists will be able to provide a limited range of antibiotics to patients who present with UTIs. “In our advocacy for this trial, we have argued that this happens safely in NZ, the UK and Canada, and the RxOUTMAP is frequently cited.”

Meanwhile, the Irish Pharmacy Union has been using the study and economic analysis to make a cost proposal to the ministry of health for expansion of pharmacist scope and services in Ireland.  “We haven’t yet secured government approval to launch the service, and regulatory change would be required,” says the Union’s Secretary General Darragh J. O’Loughlin. “But we know the benefits have been recognized and it is under active consideration."