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BackgroundBiological drugs are effective treatments for chronic plaque psoriasis. The doses tend to be reduced when the drug has demonstrated sustained effectiveness.PurposeThe main objective was to assess the average cost per patient of each anti-TNF drug based on its prescribed doses. The secondary objective was two-fold: to estimate the annual costs per responder and the incremental cost.Material and methodsA cross-sectional observational study was conducted from January to June 2014. Patients with psoriasis who had received biological treatment for at least six months were included. The effectiveness endpoint was the proportion of patients with at least 75% improvement in the psoriasis area-and-severity index (PASI75). Mean prescribed doses of each anti-TNF drug were calculated and translated into a percentage of the label doses. The average cost per patient for each drug was assessed with the mean prescribed doses (real costs, RC) and the theoretical costs (TC) were estimated based on the label doses of the drugs. The incremental cost (IC) was calculated by comparing the theoretical vs. real costs. For the purpose of calculating the annual costs, the real costs of six months of treatment were extrapolated. This study was performed from the pharmacoeconomic perspective of the hospital.ResultsWe included 143 patients.Abstract CP-142 Table 1Adalimumab (N = 45)Etanercept (N = 44)Ustekinumab (N = 32)Infliximab (N = 22)Cost per patient based on the doses prescribed€4,777.06 €4,722.38 €5,337.34 €6,546.82 Cost per patient based on its label doses€6.245.72 €5.788.19 €5,689.02 €6,546.82 Proportion of patients with PASI7598% 90% 90% 100% Estimated annual real costs per responder€9,771.27 €10,389.24 €11,778.95 €13,093.65 Estimated TC€12,491.44€11,576.38€11,378.05€13,093.65Estimated RC€9,554.13€9,444.76€10,674.68€13,093.65IC€-2,937.30€-2,131.62€-703.360€ConclusionThe average RC of each biological drug was lower than TC, except for infliximab. Both the annual RC and the IC of adalimumab were better than the other drugs, followed by etanercept and ustekinumab. Infliximab did not allow dose reduction. Reducing doses of biological treatments permits cost minimisation while maintaining clinical effectiveness.References and/or AcknowledgementsNo conflict of interest.

BackgroundTreatment modifications within the first year are extremely important. The first HAART regimen should remain for years. The first regimen toxicity can have a negative impact on adherence and virological efficacy.PurposeTo establish the main reason for discontinuing antiretroviral treatment within the first year in an HIV cohort.Material and methodsProspective multicentre study. Treatment-naive adult HIV patients who started treatment between 2011 and 2013 were selected. Basic demographic characteristics (sex and age) and pharmacotherapeutic variables as initial HAART, discontinuation of HAART within the first year and its reasons based on Swiss HIV Cohort1 were collected. The main reasons for treatment modification were classified as treatment failure, intolerance and/or toxic effects, the patient’s choice, the physician’s decision, and other reasons.Results277 patients started HAART in this period, 82.4% men. The mean age was 40 ± 11. The most frequent HAART was emtricitabine/tenofovir/efavirenz (59.1%) followed by emtricitabine, tenofovir, atazanavir/ritonavir (13.6%), emtricitabine, tenofovir, darunavir/ritonavir (9.1%) and other combinations (18.2%). During the first year of HAART, 68 individuals modified their treatment. The reason for treatment discontinuation was: 64.7% intolerance or toxic effects, 16.2% the physician’s decision 10.3% treatment failure, 4.4% the patient’s decision and 4.4% other reasons. 44 patients modified their treatment because of drug intolerance and/or drug toxicity. CNS adverse events were the most frequent toxic effect (27.3%), followed by gastrointestinal tract intolerance and renal impairment (18.2%), rash (9.1%), biochemical alterations (6.8%) and others (18.2%).ConclusionThe number of patients stopping HAART in the first year is acceptable. It is necessary to properly assess starting HAART to reduce adverse reactions involving switching the treatment.ReferenceElzi L, Marzolini C, Furrer H, et al. Treatment modification in human immunodeficiency virus-infected individuals starting combination antiretroviral therapy between 2005 and 2008. Arch Intern Med 2010;170(1):57–65. doi:10.1001/archinternmed.2009.432No conflict of interest.

BackgroundStructured and commented reviews (SCREVs) are individual assessments for drugs not included in the Pharmacotherapeutic Guide (NIPG) and off-label drugs requested by prescribers, in order to approve their use.PurposeTo describe the SCREVs performed and to estimate the financial impact of the pharmacy recommendations.Material and methodsA three-year retrospective descriptive study was designed with SCREVs performed in this period. SCREVs contained information about indications (NIPG or off-label), efficacy, safety, convenience, costs, including alternatives and cost/utility analysis, with a limit of €40,000/QALY. The final pharmacy recommendation included A (approval), B (conditional approval), C (refusal) or D (non-opposition with negative opinion). In case C the savings achieved using the average treatment time were estimated. In case D the effectiveness and the financial impact associated with the use of the drug were calculated.Results48 SCREVs were analysed: 17 off-label and 31 NIPG. The highest number of requests came from Oncology (48%). The pharmacy recommendations were: 16.6% A, 54.2% B, 18.75% C and 10.45% D.Abstract CP-134 Table 1SCREVN = 48 A(Approval)16.6% N = 8 B(Conditional approval)54.2% N = 26C(Refusal)18.75% N = 9 D(Negative opinion)10.45% N = 5€40,000/QALY N = 2Not calculated: N = 6 N = 8Not calculated: N = 10Lower cost: N = 8N = 8 Lower cost: N = 1N = 1 Not calculated: N = 4No alternative treatmentsN = 3 N = 13 N = 0 N = 2 The savings achieved with recommendation C were €229,324. The financial impact of recommendation D (all of them offered to the patients before request) was €63,447. Their effectiveness measured by overall survival (OS) and progression-free survival (PFS) were OS < 2 months, PFS < 5 months in all cases.ConclusionIndividual SCREVs were useful for taking complicated decisions about off-label and NIPG drugs use at the hospital, with important savings achieved. More than half of the drugs requested were approved with adjusted conditions of use. The cases with negative pharmacy opinions showed low effectiveness.References and/or AcknowledgementsAuthorsNo conflict of interest.

BackgroundPatient identification bracelets and their verification by infrared scanner help to minimise errors during administration of intravenous anticancer drugs.PurposeTo quantify the number of correct administrations, type of mistakes avoided and the level of implementation of the new safety system for administration of intravenous drugs.Material and methodsA retrospective descriptive study was designed with all patients who received intravenous anticancer drugs in Oncology Day Hospital (June 2014–September 2014). The identification bracelet was printed and put on the patient by the nurse. The scanner read the barcode of each intravenous preparation: chemotherapy and supportive treatment, and the Data matrix code of the bracelet with patient data. The system verified that dosages and the administration steps in the order specified in the chemotherapy management software (Farmis-Oncofarm V.2011.0.4.6) were correct. All the information was recorded in a database through a WiFi system. The end points examined were: number of correct administrations and number and type of mistakes that were avoided. The level of implementation of this system was assessed as the number of drugs preparations identified by infrared scanner compared to the total number of completed administrations.ResultsDuring the study period, 476 patients were included with 13,805 administrations (21% cytostatic drugs and 79% supportive treatments). The level of implementation obtained was 67%.Abstract PS-080 Table 1N%Correct administrations8,55992.32Mistakes avoided during medication administration5415.84Order of drug administrationWrong-patient medication errorExpired drugIncorrect date of schedulingDrug not found in the database51326111715.530.290.010.011.84Total9,271100ConclusionThe safety system was used in more than a half of administered cycles.Errors related to order of administration were the most common identified.The level of implementation of the identification system would require an improvement in order to benefit the maximum number of patients.References and/or acknowledgementsNo conflict of interest.