Interface policies bridging outpatient and hospital sectors in Europe: can cross-sectorial collaboration in reimbursement and procurement improve access to affordable medicines?

Vogler, Sabine; Salcher‐Konrad, Maximilian; Habimana, Katharina

doi:10.1080/14737167.2023.2237683

Cited by 2 publications

(2 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In most countries, outpatient and inpatient sectors of the healthcare systems are clearly separated [ 1 – 4 ]. This also applies to the reimbursement [ 1 – 4 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A newly developed algorithm for switching outpatient medications to medications listed in the hospital formulary: a prospective real-word evaluation in patients admitted electively to hospital

Möller,

Oetting,

Spiegel

et al. 2024

Eur J Clin Pharmacol

View full text Add to dashboard Cite

Purpose In many countries, outpatient and inpatient care are separated. During hospitalization, therefore, switching the outpatient medication to medication of the hospital formulary is required. Methods We newly designed a switching algorithm in six switching steps (S0–S5) and conducted a study at Bundeswehr Hospital Hamburg (300 beds, 80% civilians). We performed (i) a medication reconciliation to obtain information on outpatient medications and (ii) a medication review to solve drug-related-problems, e.g., drug-drug interactions. We applied (iii) the algorithm to switch medications to the hospital formulary. Results (i) We identified 475 outpatient medications (median per patient: 4; Q25/Q75 2/7) in 100 patients consecutively admitted to hospital (median age: 71; Q25/Q75: 64/80 years). Of 475 medications, the switching algorithm could not be used since product names were missing in 23.9% and strength in 1.7%. In 3.2%, switching was not required since medication was not prescribed during the hospital stay. (ii) Drug-drug interactions were identified in 31 of 79 patients with more than one medication. (iii) Of 475 medications, 18.5% were on the hospital formulary and therefore did not need to be switched (S0), 0.2% were on a substitution-exclusion list not allowing switching (S1), 42.0% were switched to a generic medication of the hospital formulary (S2), 1.7% to a therapeutically equivalent medication (S3), 0.4% were patient-individually switched (S4), and for 8.2% a standardized/patient-individual switching was not possible (S5). Conclusions Despite comprehensive medication reconciliation, patient- and medication-related information for switching medications to the hospital formulary was often missing. Once all the necessary information was available, standardized switching could be easily carried out according to a newly developed switching algorithm.

show abstract

“…In most countries, outpatient and inpatient sectors of the healthcare systems are clearly separated [ 1 – 4 ]. This also applies to the reimbursement [ 1 – 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…In most countries, outpatient and inpatient sectors of the healthcare systems are clearly separated [ 1 – 4 ]. This also applies to the reimbursement [ 1 – 4 ]. In contrast to outpatients, the supply of medications for inpatients is mainly provided by hospital pharmacies [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

A newly developed algorithm for switching outpatient medications to medications listed in the hospital formulary: a prospective real-word evaluation in patients admitted electively to hospital

Möller,

Oetting,

Spiegel

et al. 2024

Eur J Clin Pharmacol

View full text Add to dashboard Cite

show abstract

Drugs with the highest drug expenditure in the Republic of Serbia

Milijašević,

Milak,

Ubavić

et al. 2023

Hosp Pharm Int Multi J

View full text Add to dashboard Cite

Introduction: The policy concerning drugs represents a concentrated effort to achieve better health outcomes for all, with a particular focus on people's access to and rational use of medications. On the basis of pharmacoeconomic analyses, it is possible to modify established prescribing habits, it is possible to influence the creation of guidelines, development strategy and long-term health care planning. Aim: The aim of the work was to determine drugs with the highest expenditure in the Republic of Serbia, and to compare the results obtained in three consecutive years 2016, 2017 and 2018. Also, to analyze which are the most expensive medications listed in the National Register of Medications and what is the trend of changing them. Material and methods: The drug expenditure was monitored using the ATC/DDD methodology. It implies the classification of medications according to the internationally accepted ATC classification of drugs, while DDD, i.e. defined daily dose, is used as a statistical unit for consumption monitoring. The number of DDD/1,000 inhabitants per day provides an insight into how many inhabitants (out of 1,000 of them) used the observed medication and were exposed to its effects during one day. Results: The trend of expenditure of these medications was growing exponentially from 2016 to 2018. The most expensive medications per box are from group J - anti-infective drugs for systemic use and L - antineoplastics and immunomodulators, but their expenditure in the Republic of Serbia is very low. The drugs with the highest price per 1 DDD are: enzymes imiglucerase, laronidase and the biological medication basiliximab in all three years, but considering the indications and rare prescribing, the total cost for these drugs is not high. The largest funds in the Republic of Serbia for the mentioned period were spent on drugs such as: acetylsalicylic acid, paracetamol in combinations, trastuzumab, pantoprazole, amlodipine and rosuvastatin. Comparing the spending on L group of drugs in 2017 compared to 2016, there was a significant increase. Conclusion: The medications with the highest expenditure in the Republic of Serbia are used very little compared to countries with good pharmacotherapy practice. The most expensive drugs are those that are used for special and rare indications, and large amounts of money are not allocated for them as for some cheaper, but more frequently prescribed drugs.

show abstract

Interface policies bridging outpatient and hospital sectors in Europe: can cross-sectorial collaboration in reimbursement and procurement improve access to affordable medicines?

Cited by 2 publications

References 38 publications

A newly developed algorithm for switching outpatient medications to medications listed in the hospital formulary: a prospective real-word evaluation in patients admitted electively to hospital

A newly developed algorithm for switching outpatient medications to medications listed in the hospital formulary: a prospective real-word evaluation in patients admitted electively to hospital

Drugs with the highest drug expenditure in the Republic of Serbia

Contact Info

Product

Resources

About