Acceptability and consumers' willingness to pay for comprehensive medication management services in Brazil
Publication: Journal of Comparative Effectiveness Research
Abstract
Aim: Comprehensive medication management (CMM) is a clinical service that aims to optimize the therapeutic results of patients at the individual level. Studies carried out in Brazil and in several parts of the world have found a positive impact of the service, mainly in the resolution of drug therapy problems and in improving clinical outcomes and patients' quality of life. This service is not widespread and its acceptability and willingness to pay were not defined by the population yet. Objective: This work aims to conduct a study with users of private health services to determine the acceptability and willingness to pay for CMM services. Methods: This is a cross-sectional survey conducted through face-to-face interviews, among residents over 18 years of age of the metropolitan region of Belo Horizonte, capital of Minas Gerais State, Brazil. Results: For this study, 563 individuals were interviewed. Most respondents were female (55.1%), had completed high school (46.8%) and were employed (62.5%). The acceptability for the service was 93,25%, and among all respondents, 37 would not accept the service even if it was free. The amount of consumers' willingness to pay for the CMM service was estimated at $17.75 (40.00 BRL). Conclusion: The research results show that most people are willing to pay for the CMM service. This study can contribute to the decision-making regarding the implementation and pricing of the service in Brazil.
Tweetable abstract
Study examines willingness to pay for comprehensive medication management (CMM) services in Brazil, with findings that may assist healthcare administrators and insurers in implementing and pricing CMM services.
Plain language summary
What is this article about?
This article discusses a medical service called comprehensive medication management (CMM), which aims to make sure patients get the best results from their medications. Studies from different parts of the world, including Brazil, have shown that this service can solve problems related to medications and improve the health and quality of life of patients. However, not many people use this service, and it is not clear if people would be interested in using it or how much they would be willing to pay for it. So, researchers did a study in Belo Horizonte, Brazil, where they asked over 18-year-old residents about their thoughts on CMM.
What were the results?
They found that most of the 563 people they interviewed were okay with using this service, with about 93% of them saying they would be interested. Only 37 people out of all respondents said they would not want the service, even if it was free. The study also estimated that on average, people would be willing to pay about $17.75 (which is around 40.00 Brazilian Reals) for the CMM service.
What do the results of the study mean?
The study suggests that a lot of people are open to using the CMM service and are willing to pay for it. These findings could help health authorities in Brazil decide how to offer and price this service to benefit more people.
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References
Papers of special note have been highlighted as: • of interest
1.
Patient-Centered Primary Care Collaborative. The Patient-Centered Medical Home: Integrating Comprehensive Medication Management to Optimize Patient Outcomes (2012). https://thepcc.org/sites/default/files/media/medmanagement.pdf
2.
Cipolle R, Strand L, Morley P. Pharmaceutical Care Practice: The Patient-Centered Approach to Medication Management (3rd Edition). McGraw-Hill Education, NY, USA (2012).
3.
Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am. J. Heal. Pharm. 47(3), 533–543 (1990).
4.
Isetts BJ, Schondelmeyer SW, Artz MB et al. Clinical and economic outcomes of medication therapy management services: the Minnesota experience. J. Am. Pharm. Assoc. 48(2), 203–214 (2008).
5.
Ramalho de Oliveira D, Brummel AR, Miller DB. Medication therapy management: 10 years of experience in a large integrated health care system. J. Manag. Care Pharm. 16(3), 185–195 (2010).
6.
Sá-Borges AP, Guidoni CM, Freitas O, Pereira LRL. Economic evaluation of outpatients with Type 2 diabetes mellitus assisted by a pharmaceutical care service. Arq. Bras. Endocrinol. Metab. 55(9), 686–691 (2011).
7.
Balisa-Rocha BJ, Guimarães VG, Mesquita AR, Aguiar PM, Krass I, de Lyra Júnior DP. Enhancing health care for type 2 diabetes in Northern Brazil: a pilot study of pharmaceutical care in community pharmacy. African J. Pharm. Pharmacol. 6(35), 2584–2591 (2012).
8.
Mourão AOM, Ferreira WR, Martins MAP et al. Pharmaceutical care program for Type 2 diabetes patients in Brazil: a randomized controlled trial. Int. J. Clin. Pharm. 35, 79–86 (2013).
9.
Viswanathan M, Kahwati LC, Golin CE et al. Medication therapy management interventions in outpatient settings. JAMA Intern. Med. 175(1), 76–87 (2015).
10.
Santos BD, Nascimento MMGD, de Oliveira GCB et al. Clinical impact of a comprehensive medication management service in primary health care. J. Pharm. Pract. 34(2), 265–271 (2021).
11.
Neto PRO, Marusic S, de Lyra Júnior DP et al. Effect of a 36-month pharmaceutical care program on the coronary heart disease risk in elderly diabetic and hypertensive patients. J. Pharm. Pharm. Sci. 14(2), 249–263 (2011).
12.
Brown LM, Rashrash ME, Schommer JC. The certainty in consumers' willingness to accept pharmacist-provided medication therapy management services. J. Am. Pharm. Assoc. 57(2), 211–216 (2017).
• Focuses on consumers' willingness to accept pharmacist-provided medication therapy management services.
13.
Mendonça S de AM, Melo AC, Pereira GCC et al. Clinical outcomes of medication therapy management services in primary health care. Brazilian J. Pharm. Sci. 52(3), 365–373 (2016).
14.
Detoni KB, Oliveira IV, Nascimento MMG, Caux TR, Alves MR, Ramalho-de-Oliveira D. Impact of a medication therapy management service on the clinical status of patients with chronic obstructive pulmonary disease. Int. J. Clin. Pharm. 39(1), 95–103 (2017).
15.
Brajković A, Bićanić LA, Strgačić M, Orehovački H, Ramalho-de-Oliveira D, Mucalo I. The impact of pharmacist-led medication management services on the quality of life and adverse drug reaction occurrence. Pharmacy (Basel) 10(5), 102 (2022).
16.
Brajkovíc A, Bosnar L, Nascimento MMG et al. Healthcare utilization and clinical outcomes in older cardiovascular patients receiving comprehensive medication management services: a nonrandomised clinical study. Int. J. Environ. Res. Public Health 19(5), 2781 (2022).
17.
Agência Nacional de Saúde Suplementar. Rol de Procedimentos e Eventos em Saúde (2018). http://www.ans.gov.br/images/stories/Plano_de_saude_e_Operadoras/Area_do_consumidor/rol/2020/anexo-i-rol-2018-alterado-pelas-rns-453-457-revogacao-458-460-2020-crn.pdf
18.
Mitchell R, Carson R. Using Surveys to Value Public Goods: The Contingent Valuation Method (1st Edition). Resources for the Future (RFF) Press, USA (1989).
19.
Johannesson M, Johansson P-O, Jönsson B. Economic evaluation of drug therapy: a review of the contingent valuation method. Pharmacoeconomics 1(5), 325–337 (1992).
20.
Painter JT, Gressler L, Kathe N, Slabaugh SL, Blumenschein K. Consumer willingness to pay for pharmacy services: an updated review of the literature. Res. Soc. Adm Pharm. 14(12), 1091–1105 (2018).
• A review of consumers' willingness to pay for pharmacy services, providing an updated analysis of the literature.
21.
Haab T, McConnell K. Valuing Environmental and Natural Resources: The Econometrics of Non-Market Valuation. Edward Elgar Publishing, UK (2002).
22.
Drummond M, Sculpher M, Claxton K, Stoddart G, Torrance G. Methods for the Economic Evaluation of Health Care Programmes (4th Edition). Oxford University Press, York, UK (2015).
23.
Wang J, Hong SH. Contingent valuation and pharmacists' acceptable levels of compensation for medication therapy management services. Res. Soc. Adm Pharm. 11(3), e121–e132 (2015).
• Focuses on pharmacists' acceptable levels of compensation for medication therapy management services using the contingent valuation method.
24.
Simonson I, Drolet A. Anchoring effects on consumers' willingness-to-pay and willingness-to-accept. J. Consum. Res. 31(3), 681–690 (2004).
25.
Agência Nacional de Saúde Suplementar. ANS define regras para cobrança de coparticipação e franquia em planos de saúde (2018). http://www.ans.gov.br/aans/noticias-ans/consumidor/4499-ans-define-regras-para-cobranca-de-coparticipacao-e-franquia-em-planos-de-saude
26.
Agência Nacional de Saúde Suplementar. Painel de Precificação: Planos de Saúde. Agência Nacional de Saúde Suplementar, Rio de Janeiro (2018). https://www.gov.br/ans/pt-br/arquivos/assuntos/consumidor/reajustes-de-mensalidade/reajuste-anual-de-planos-individuais-familiares/painel_de_precificacao_planos_de_saude_2017.pdf
27.
Furnham A, Boo HC. A literature review of the anchoring effect. J. Socio. Econ. 40(1), 35–42 (2011).
28.
Instituto Brasileiro de Geografia e Estatística (2021). https://cidades.ibge.gov.br/brasil/mg/belo-horizonte/panorama
29.
United Nations Development Programme. Human Development Report 2020 (2020). http://hdr.undp.org/sites/default/files/hdr2020.pdf
30.
Ministério da Saúde. Departamento de Informática do Sistema Único de Saúde (DATASUS). TabNet ANS (2023). https://datasus.saude.gov.br/home/tabnet/
31.
Paim J, Travassos C, Almeida C et al. The Brazilian health system: history, advances, and challenges. Lancet 377(9779), 1778–1797 (2011).
32.
Godói IP, Santos AS, Reis EA et al. Consumer Willingness to Pay for Dengue Vaccine (CYD-TDV, Dengvaxia®) in Brazil; Implications for Future Pricing Considerations. Front Pharmacol. 8, 41 (2017).
• Analyzes consumers' willingness to pay for a dengue vaccine in Brazil. It was the first study using the CV method in the health analysis in Brazil.
33.
Muniz Júnior RL, Godói IP, Reis EA et al. Consumer willingness to pay for a hypothetical Zika vaccine in Brazil and the implications. Expert Rev. Pharmacoecon. Outcomes Res. 19(4), 473–482 (2019).
34.
Sarmento TTR, Godói IP, Reis EA, Godman B, Ruas CM. Consumer willingness to pay for a hypothetical chikungunya vaccine in Brazil and the implications. Expert Rev. Pharmacoecon. Outcomes Res. 22(3), 513–520 (2022).
35.
Johnston RJ, Boyle KJ, Adamowicz W (Vic) et al. Contemporary guidance for stated preference studies. J. Assoc. Environ. Resour. Econ. 4(2), 319–405 (2017).
36.
Bryman A. Integrating quantitative and qualitative research: how is it done? Qual. Res. 6(1), 97–113 (2006).
37.
The World Bank. PPP conversion factor (2019). https://data.worldbank.org/indicator/PA.NUS.PPP?locations=BR
38.
Truong HA, Groves CN, Congdon HB, Dang DT, Botchway R, Thomas J. Potential cost savings of medication therapy management in safety-net clinics. J. Am. Pharm. Assoc. 55(3), 269–272 (2015).
39.
Winterstein AG, Sauer BC, Hepler CD, Poole C. Preventable drug-related hospital admissions. Ann. Pharmacother. 36(7–8), 1238–1248 (2002).
40.
O'Dwyer G, Konder MT, Machado CV, Alves CP, Alves RP. The current scenario of emergency care policies in Brazil. BMC Health Serv. Res. 13, 70 (2013).
41.
Jaber D, Aburuz S, Hammad EA, El-Refae H, Basheti IA. Patients' attitude and willingness to pay for pharmaceutical care: an international message from a developing country. Res. Soc. Adm Pharm. 15(9), 1177–1182 (2019).
• Investigates patients' attitudes and willingness to pay for pharmaceutical care, focusing on a developing country.
42.
World Population Review. Country Rankings. Middle-Income Countries 2023. https://worldpopulationreview.com/country-rankings/middle-income-countries
43.
Hanna A, White L, Yanamandram V. Patients' willingness to pay for diabetes disease state management services in Australian community pharmacies. Int. J. Pharm. Healthc. Mark. 4(4), 339–354 (2010).
44.
Woelfel JA, Carr-Lopez SM, Santos MD et al. Assessing Medicare beneficiaries' willingness-to-pay for medication therapy management services. Consult. Pharm. 29(2), 104–109 (2014).
• Examines Medicare beneficiaries' willingness to pay for medication therapy management services.
45.
Chisholm-Burns MA, Lee JK, Spivey CA et al. US pharmacists' effect as team members on patient care. Med. Care 48(10), 923–933 (2010).
46.
Tilton JJ, Edakkunnathu MG, Moran KM et al. Impact of a medication therapy management clinic on glycosylated hemoglobin, blood pressure, and resource utilization. Ann. Pharmacother. 53(1), 13–20 (2019).
47.
Bertakis KD, Azari R, Helms LJ, Callahan EJ, Robbins JA. Gender differences in the utilization of health care services. J. Fam. Pract. United States 49(2), 147–152 (2000).
48.
Schumacher L, Coe AB, Lester CA, Rothermal M, Dorsch MP. Factors that influence patient acceptance of clinical pharmacy services: a nationwide survey. J. Am. Pharm. Assoc. 60(6), 1058–1067; e4 (2020).
• Investigates factors that influence patients' acceptance of clinical pharmacy services.
49.
Schultz BG, Tilton J, Jun J, Scott-Horton T, Quach D, Touchette DR. Cost-effectiveness analysis of a pharmacist-led medication therapy management program: hypertension management. Value Health 24(4), 522–529 (2021).
50.
do Amaral PA, Mendonça S de AM, de Oliveira DR, Peloso LJ, Pedroso R dos S, Ribeiro MÂ. Impact of a medication therapy management service offered to patients in treatment of breast cancer. Brazilian J. Pharm. Sci. 54(2), e00221 (2018).
51.
Cookson R. Willingness to pay methods in health care: a sceptical view. Health Econ. 12(11), 891–894 (2003).
52.
Instituto Brasileiro de Geografia e Estatística. Pesquisa Nacional de Saúde 2019 (2020). https://biblioteca.ibge.gov.br/visualizacao/livros/liv101748.pdf
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Received: 2 August 2023
Accepted: 18 January 2024
Published online: 8 February 2024
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Acceptability and consumers' willingness to pay for comprehensive medication management services in Brazil. (2024) Journal of Comparative Effectiveness Research. DOI: 10.57264/cer-2023-0127
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