Background: Pharmacists play a key role in ensuring the safe use of injectable antineoplastics, which are considered as high-alert medications. Pharmaceutical analysis of injectable antineoplastic prescriptions aims to detect and prevent drug related problems by proposing pharmacist interventions (PI). The impact of this activity for patients, healthcare facilities and other health professionals is not completely known. This study aimed at describing the clinical, economic, and organizational impacts of PIs performed by pharmacists in a chemotherapy preparation unit.Methods: A prospective 10-week study was conducted on PIs involving injectable antineoplastic prescriptions. Each PI was assessed by one of the four multidisciplinary expert committees using a multidimensional tool with three independent dimensions: clinical, economic and organizational. An ancillary quantitative evaluation of drug cost savings was conducted. Results: Overall, 185 patients were included (mean age: 63.5 ± 13.7 years; 54.1% were male) and 237 PIs concerning 10.1% prescriptions were recorded. Twenty one PIs (8.9%) had major clinical impact (ie: prevented hospitalization or permanent disability), 49 PIs (20.7%) had moderate clinical impact (ie: prevented harm that would have required further monitoring/treatment), 62 PIs (26.2%) had minor clinical impact, 95 PIs (40.0%) had no clinical impact, and 9 PIs (3.8%) had a negative clinical impact. For one PI (0.4%) the clinical impact was not determined due to insufficient information. Regarding organizational impact, 67.5% PIs had a positive impact on patient management from the healthcare providers' perspective. A positive economic impact was observed for 105 PIs (44.3%), leading to a saving in direct drug costs of 15,096 €; 38 PIs (16.0%) had a negative economic impact, increasing the direct drug cost by 11,878 €. Overall cost saving was 3218€. Conclusions: PIs are associated with positive clinical, economic and organizational impacts. This study confirms the benefit of pharmacist analysis of injectable antineoplastic prescriptions for patient safety with an overall benefit to the healthcare system.

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Background Drug supply and stock management are part of the hospital pharmacist’s job. Financial restraints imposed by our institution have led us to consider reducing the value of drugs stocked within the pharmacy. Therefore we decided to implement the ABC (Activity Based Costing) method for drug supply. Purpose To present results obtained by this method in our pharmacy. Materials and methods About 1800 drugs were divided into three classes: class A represents 20% in quantity and 80% of the stock value, class B represents 30% in quantity and 15% of the stock value and class C represents 50% in quantity and 5% of the stock value. If possible, class A drugs were ordered twice a month; class B drugs once a month, and class C every 45 days. Simultaneously indicators were used to follow up the procedure. This method was used from June to August. Results A 7.8% drop in the average stock value was recorded after two months; it fell from 3.2 million euros to 2.9 million euros (maximum 3.5 million euros, minimum 2.6 million over the 3 months study). Stock coverage decreased from 17.4 days in June to 11.7 in August for expensive drugs and from 46.9 days to 32.0 for other drugs. At the same time, the number of order lines to manufacturers rose from 1,943 lines in June to 2,003 in July and to 1,896 in August. Conclusions This method cannot be used for all drugs, such as antidotes, which require buffer stock. This management approach has helped us to reduce stock value consistently. We will also have to include the acquisition cost in the global approach to the drug supply chain. No conflict of interest.