database including approximately 6.7 million insured anonymities originating from 63 statutory health insurances. Analyses were performed by the InGef institute. A sample with approximately 4 million insured persons was drawn and stratified by age and gender according to the official demographic structure of the German statutory health insured population (DeStatis, Dec 31st, 2013). Patient data from 2012 -2016 were included if they met the following conditions: Main diagnosis of PsO (ICD-10 code L40.-), and start / maintenance / switch of treatment with PsO approved biological agent(s) (at least for three months). The study evaluated hospital admission, change in medication and direct medical costs (drug, outpatient care, hospitalization). Results: Leading biological agents for 1st line treatment of PsO are adalimumab and apremilast, however, at a low level of share of prescriptions. Adalimumab and etanercept are administered mostly to patients already on treatment (in 2015 adalimumab 40.4 % vs. etanercept 26.6 %). The total costs of the included 2'041 patients add up to € 36'874'827 in 2015. The total number of patients, the number of hospital admissions and the total treatment costs including all individual cost items grew yearly on average between 1. 7% and 14.5 % (2012 -2015). Hospitalization per patient declined slightly from 0.8 to 0.7. ConClusions: Adalimumab, apremilast and etanercept are those biological agents mainly used for treating PsO. All cost items grew steadily over the last 4 years. Total costs in 2015 were € 36.9 million (on average € 18'067 per patient).

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BackgroundThe increase in the total number of drugs dispensed in the hospital pharmacy dispensation area (DA) requires broader knowledge and new methodologies for pharmaceutical care (PC).This involves prevention, identification and resolution of drug related problems (interactions, therapeutic adherence, adverse reactions, etc) and information to patients.PurposeTo study the type of PC that is applied and in which pathologies this resource is being more used at the moment.Material and methodsA survey was conducted on the different aspects related to the organisation, human and physical resources assigned to this area and type of assistance received by outpatients.Results105 hospitals completed the survey. 42% (44) had 101–300 beds, 25% (26) had 301–500 beds, 17% (18) had 501–1000 beds, 7% (7) had >1000 beds and 9% (10) had <100 bed, and the average number of pharmacists were 4, 6, 12, 9 and 1, respectively.94% (99) of hospitals performed PC. 49% (48) had 1 pharmacist in charge for this task, 29% (29) had 2, 8% (8) had 3 and 14% (14) had 4 or more pharmacists.In all hospitals in which PC was in place, this was performed at the beginning of treatment; however, in only 56% (55) of cases were there follow-up visits which were either monthly (26%), quarterly (28%) or semi-annually (10%).92% of hospitals performed PC in HCV, 92% in oncologic-haematologic diseases, 88% in HIV, 87% in rheumatoid arthritis, 81% in multiple sclerosis and 74% in HBV.The pharmacist dispensed the medication in 90 of the 105 hospitals. In addition, other personnel involved in this task included pharmacy technicians (36%), nurse assistants (44%), higher degree technicians (8%) and nurses (18%).ConclusionVariability was observed at hospitals DA concerning both human and physical resources.Not all hospitals did PC for the same pathologies, nor with the same frequency. A prevalence of PC for HCV, oncologic-haematologic diseases and HIV was shown in this study compared with other pathologies.The differences observed in terms of outpatient dispensation PC models make us think that guidelines on how to develop the activity and how to distribute the resources are necessary.No conflict of interest.