Community pharmacists have been reimbursed by the federal government to perform Home Medicine Reviews (HMRs) for home-dwelling residents since 2001 (1) . Prior to the implementation of the HMR program, several Australian studies found pharmacist-conducted medication reviews to be feasible and effective (1-7) .

Most of these studies found that HMRs resulted in the resolution of drug-related problems (DRPs) and showed trends in reduced medication costs. Two of these studies evaluated the economic viability of home medication reviews. The first of these (the St. George project) found that following an HMR, the monthly cost of medication taken by patients decreased by $18.29 (9.1%) (3) . A second study, the Quality Use of Medicines in the Community Implementation Trial, attributed a health system saving of $120 per patient per anum to HMRs (2) .

A 2005 evaluation of the HMR program used a consumer survey and available studies to perform a cost-benefit analysis (2) . This evaluation found that the evidence for the effects on long-term health outcomes was limited at this stage. However, the evaluation concluded that the program was cost-effective in terms of both cost savings and quality adjusted life years (QALY) gained. A recommendation in this report was that “there is a need for… information on health outcomes for patients who have had an HMR”.

Recent international studies of pharmacist-conducted medication reviews have been highly critical of them (8-13) . Several trials performed in the United Kingdom have failed to demonstrate that medication reviews result in a reduction in mortality or hospital admissions (8-11) . Some of these studies found increased health service utilisation and no improvement in quality of life or mortality within 12 months of a pharmacist conducted medication review (11) .

There is a need to quantify the economic benefits of the Australian HMR program. The VALMER project aims to determine the value of a sample of HMRs in terms of healthcare costs (such as GP and specialist visits avoided, worsening of the underlying disease, hospital days avoided etc.), as estimated independently by a panel of medication experts. In addition, the types of problems identified, the drugs involved, and the ways the problem was resolved will be evaluated.

The data from the VALMER project will be invaluable for ensuring the ongoing funding of the HMR program. Additionally, with this information, it will be possible to further improve the HMR process. The nature of the information available will allow for the identification of particular medications or medication groups and/or particular types of problems that may be more serious in terms of potential cost of health consequences.

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