CP-134 Analysis of structured and commented individualised drugs reviews made by hospital pharmacy department

Abstract

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.