An analysis of medicines optimisation solutions

How we worked with FirstData Bank

Based on extensive experience of real-world evaluations, Unity Insights were commissioned by FirstData Bank (FDB) to conduct a high-level cost-benefit analysis of OptimiseRx and AnalyseRx. These solutions aim to enhance medicines optimisation both proactively and at the point of care. The analysis included a literature review, basic quantitative analysis, and an initial high-level cost-benefit overview, comparing the potential health economic outcomes of actioning the relevant fluroquinolone and direct oral anticoagulants (DOAC) messages.

What were the impacts of this analysis?

The preliminary high-level cost-benefit analysis assessed the impact of the messages, in alignment with The Green Book (HM Treasury, 2022)
methodology. The predominant evidence sources used to develop this analysis were the performance data, and academic research, which was provided by FDB and validated by Unity Insights.

OptimiseRx: Value for money

The findings indicate positive benefit-cost ratios (BCRs) and net present values (NPVs) for fluoroquinolone messages when compared to a proportionate costing structure. This means that the monetizable benefits from the fluoroquinolone messages were compared by dividing the number of fluoroquinolone messages by the thousands of national messages. If implemented across the English population, OptimseRx is expected to have a five-year NPV of £2.5 million and a BCR of 4.7, indicating a £4.70 return for every £1 spent. Cash-releasing benefits, such as avoided medication costs and Clostridium difficile (CD) treatment costs, contribute 75% of the return. However, the results are negative when the fluroquinolone benefits alone are compared to the entire OptimiseRx solution cost. This means that the monetisable benefits from only the fluroquinolone messages do not offset the entire cost per patient. This finding is not surprising as you would not expect less than 1% of the available messages to account for all of the solution benefits.

AnalyseRx: Value for money

When comparing the benefits of DOAC opportunities to a proportionate costing structure, the findings revealed positive BCRs and NPVs. Considering implementation across the English population, AnalyseRx is projected to have a five-year NPV of £682k and a BCR of 1.3, indicating a £1.30 return for every £1 spent. The most substantial benefit was the reduction in stroke and bleed risk, contributing £2.2m (77% of the total return). As with OptimiseRx, when compared to the entire cost of the AnalyseRx solution, the results were negative. This finding is not surprising given that around 2% of the opportunities were assessed within this scenario.

Therefore, the OptimiseRx and AnalyseRx findings demonstrate that the platform’s design to deliver multiple messages and opportunities across various diseases could be cost-effective. However, deployment of the solution for just fluroquinolones, or DOACs alone should not be considered the sole use-case.

What value did this analysis add?

Unity Insights provided recommendations which seek to further understand how effectiveness and uptake of FDB’s solutions can be enhanced.   

The primary recommendation for OptimiseRx is to conduct further qualitative research to understand the reasons why clinical staff in primary care may not respond to certain messages. It is important to consider factors such as systemic pressures, high patient volumes, decision fatigue, and resource availability.

For AnalyseRx, it is recommended to determine the most efficient level at which to implement the solution, whether that be within individual GP practices, Primary Care Networks (PCNs), or Integrated Care Boards (ICBs). Furthermore, consideration should be given to the optimal frequency of use, ensuring the tool engages relevant populations proactively without imposing excessive administrative burdens on teams.