4CPS-312\u2005Pharmaceutical interventions in a non-oncohaematological daily hospital

Abstract

Background and importance The role of the pharmacist in the validation and dispensing of medications is already known. But the increasingly frequent use of high cost drugs makes that role essential for the sustainability of health systems. Aim and objectives To describe and analyse the pharmaceutical interventions carried out in a non-oncohaematological daily hospital (NOHDH) and to evaluate the economic impact of these interventions. Material and methods From April 2019 to March 2020, pharmacist interventions in the validation and dispensing of electronic prescriptions of intravenous treatments in the NOHDH were recorded. It should be noted that preparation of infusions is not centralised in the pharmacy but is carried out in the daily hospital units. Infusions prepared in the pharmacy, acute treatments and intravenous iron were excluded. To calculate the economic impact, only the dose administered and the average cost of drugs during the year of the study were considered. Results 30 interventions were carried out in 434 patients (6.9% patients) and 2240 dispensations (1.3% dispensations). 29 were accepted (97%). They were classified according to the type of intervention: 15 presentation changes (14 to a biosimilar), 10 dose adjustments (5 to commercial presentations), 4 request errors (1 of dose and 3 of administration date) and 1 change of medication. Intervention according to services: 10 rheumatology (9.6% of patients and 2.2% of dispensations), 5 nephrology (26.3% and 11.4%), 4 digestive (2% and 0.4%), 4 neurology (11.1% and 1.3%), 3 nursing unit (0.7% and 0.13%), 1 haematology (7.7% and 1.9%), 1 allergy (4.3% and 0, 61%), 1 paediatrics (10% and 2%) and other (9.1% and 3.6%). Intervention according to drug: 10 rituximab (23.3% and 11.5%), 7 infliximab (3.6% and 0.74%), 5 immunoglobulins (9.8% and 1.1%), 4 tocilizumab (16.7% and 3.3%), 3 vedolizumab (5.6% and 1.1%) and 1 reslizumab (4.3% and 0.7%). The total estimated savings from performing the interventions was 12 186.9€ (406.2€/intervention). Conclusion and relevance Approximately half of the interventions carried out consisted of exchange to the biosimilar drug, after consensus. Although the number of interventions was low, their economic impact is important. Despite not being able to prepare these medications centrally and individually, the validation of the prescription and monitoring of the dispensations by the pharmacist is essential. References and/or acknowledgements Conflict of interest No conflict of interest