BackgroundThe prescriptions of biologics are increasing as new indications and drugs are authorised. Since biosimilar drugs were introduced in the pharmaceutical market, they have become an alternative to continuing with the demand at competitive costs.PurposeTo analyse the economic impact from incorporating the biosimilar infliximab in the hospital pharmacotherapeutic guide.Material and methodsRetrospective observational study in a third-level hospital. The study period is September 2016 to May 2017. The data are obtained for the preparation and dispensing of an intravenous mixtures program. The selected patients were all those treated with infliximab biosimilar since its incorporation into the pharmacotherapeutic guide of the hospital. The studied variable is the savings derived when using the biosimilar drug compared to the original drug.ResultsThe study included 76 patients from different medical services: digestive, rheumatology, dermatology and systemic diseases. A total of 201 administrations of infliximab biosimilar were performed in the 8 month study period and 749 drug vials were used. The price of the biosimilar drug vial is €336, whereas the original drug cost is €418.29, the economic saving produced in the administration of infliximab biosimilar in 8 months being €61 635.ConclusionThe biosimilar drugs market is increasing, which leads us to conduct studies in daily clinical practice, both in terms of efficacy and safety as well as economic savings. In the study carried out in our pharmacy service, an economic advantage of the biosimilar drug versus the original drug is clearly demonstrated. It is important to find efficient treatments for the public health system.No conflict of interest
In the period under review, 85.9 g of bevacizumab, 37.5 g of cetuximab and 43.8 g trastuzumab were prepared using material that would previously have been discarded. This provided considerable saving for the three drugs (€29,893) which corresponds to approximately €90,000 per year. Conclusions The centralised system and the use of APOTE-CAchemo is successful both in terms of patient and operator safety and cost benefit for the Hospital. No conflict of interest. Developing a Safe SyStem to preScribe, prepare anD aDminiSter cytoStatic DrugS
Background Hospitals are putting in place more systems to improve the use of medicines. Since 2010, the Pharmacy Service has regularly been using a Medicines Reconciliation (MR) System at admission to the General Surgery, Urology and Orthopaedic Surgery wards. Purpose To assess the level of satisfaction of specialist and nurses with the MR System at hospital admission. Materials and methods An anonymous satisfaction survey with four questions was designed with the intention of identifying the subjects’ opinion about the following: the daily presence of the pharmacist on the ward; the extent to which MR may improve patients’ safety and clinical condition. Finally, the subjects were asked to evaluate the MR system as a whole. We used a Likert scale from 1 = full disagreement to 5 = full agreement. The head of each Service and the nurse supervisor were informed about the aims of the survey, and later on the services themselves were in charge of handing out the survey to their staff from March to May 2012. Results 100 surveys were filled in. 68.5% of specialists and 60% of nurses participated in this project. 92.3% of nurses fully agreed with the daily presence of the pharmacist in the ward, whereas only 52.5% of specialists did. Regarding the patients’ clinical condition the survey showed that 50% of specialists and 92.3% of nurses fully agreed with the positive effect of MR. 71.8% of nurses and 62.3% of specialists fully agreed that the patient’s safety improved due to MR. The overall assessment concluded that 40% of specialists gave the system full marks (5 out of 5); 15.4% of nurses were in agreement and 84.6% in full agreement. Conclusions In general, a high degree of satisfaction with MR was detected in the Surgery Services, more particularly among nurses. No conflict of interest.
BackgroundBased on available evidence and its benefit/risk balance, acetylsalicylic acid (ASA) is the first-line antiplatelet drug of choice for secondary prevention of cardiovascular events. It is recommended to be used at low doses, not exceeding 150 mg/day. This dosage has proved to be effective enough for the prevention of vascular events, both primary and secondary ones, whereas higher doses do not significantly increase the vascular protective effect but are associated with an increased risk of side-effects.PurposeTo identify all patients with maintenance doses of ASA greater than 150 mg/day and reduce these dosages to correct them according to the evidence.Material and methodsSeven-month pre/post intervention study. The pharmacy service obtained the list of outpatients from the area on ASA treatment through the prescription data program. Data were exported to an Excel® spreadsheet where more than 150 mg/day doses were identified. This information was sent to the general practitioners (GPs) so they could modify the drug doses when required.The intervention impact was evaluated at the pharmacy service by reviewing the prescription of the patients sent in the Excel spreadsheet. The appropriateness of the maintenance dosage was checked and the modified or suspended prescription when more than 150 mg/day prescription, detected.ResultsThere were 455 patients in the area on ASA treatment at high doses (>150 mg/day) for more than 2 months. A self-audit of 79.78% (363) patients was performed in a 3 month period, with a mean age of 73±11 (±SD) years, being 48% males. A total of 228 (62.81%) inadequacies were detected. As a result of the self-audit, 4.41% of treatments (16) were suspended and the dose of 58.4% of patients (212) was modified.ConclusionThere is a high percentage of patients with an inadequate prescription of ASA. This seems to be favoured by the low perception of the risk derived from a dose that, although inadequate, is considered ‘low’ by both the patient and the prescriber.Once more, pharmaceutical intervention has proven to be an effective tool in the detection and resolution of patient safety problems.References and/or AcknowledgementsASA data sheet.NICE guidance on antiplatelet therapy following myocardial infarction.No conflict of interest
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