Pilar Modamio Charles

Estudio de la efectividad de tres esquemas de administración de factores estimuladores de la eritropoyesis en pacientes con anemia asociada a quimioterapia por una neoplasia sólida o hematológica

BACKGROUND AND OBJECTIVE: The treatment of chemotherapy associated anemia in patients with cancer has varied greatly in recent years. The objective of this study was to verify whether the most frequently used therapeutic schedules of erythropoietin administration demonstrate equivalent effectiveness. PATIENTS AND METHOD: Treatments corresponding to 1,103 patients with cancer receiving treatment with erythropoietic colony-stimulating factors from January 2003 to April 2006 were reviewed. After applying a selection algorithm, 170 cases were analysed: 55 treated with epoetin alpha 10,000 IU 3 times per week, 63 receiving darbepoetin alpha 150 microg weekly and 52 treated with darbepoetin alpha 500 microg every 3 weeks. The main variables used to compare effectiveness were the increase in serum hemoglobin levels during treatment and the percentage of patients with hemoglobin values > or = 120 g/l. RESULTS: The differences in maximum hemoglobin values achieved at baseline and during the study period, and those between the final and baseline hemoglobin values were similar in the 3 groups. The percentage of patients with hemoglobin values > or = 120 g/l during and at the end of treatment was equivalent for the group receiving epoetin alpha 10,000 IU three times per week and darbepoetin alpha 150 microg per week. However this parameter war inferior for the group treated with darbepoetin alpha 500 microg every 3 weeks. CONCLUSIONS: Epoetin alpha 10,000 IU 3 times per week was found to be as effective as darbepoetin alpha 150 microg per week in all the studied parameters, while darbepoetin alpha 500 microg every 3 weeks was not in one of them.

Evaluación del impacto de la utilización de medicamentos en dosis unitarias en 2 centros de atención primaria

Resumen Objetivo Evaluar el impacto económico de la utilización de medicamentos envasados en dosis unitaria (DU) independiente (Onedose®), en comparación con la prescripción de preparados en envase multidosis habitual. Diseño del estudio Se ha realizado un análisis de minimización de costes desde la perspectiva del centro prescriptor. El diseño del estudio es observacional retrospectivo e incluye todas las prescripciones de los 23 productos analizados realizadas entre enero y abril de 2012. Emplazamiento El estudio se ha realizado en 2 centros de atención primaria de la provincia de Barcelona. El primero urbano con 24.500 personas de cobertura y el segundo semiurbano que cubre a 10.000 personas. Mediciones principales Para cada producto analizado se midió en el periodo de estudio y se extrapoló anualmente, en función de los resultados de los escenarios de sustitución definidos, el ahorro total en euros, ahorro derivado de precio y ahorro derivado de las dosis no prescritas. Resultados El ahorro que en los centros analizados supondría haber utilizado Onedose® en vez de las presentaciones prescritas se sitúa en el período analizado sobre los 45.000 euros (24%) y anualmente en 133.000 euros. Se evitarían en el período estudiado unas 212.000 unidades galénicas (14%) de los medicamentos analizados y anualmente 669.000. Conclusiones En los centros analizados la utilización de este tipo de medicamentos puede suponer reducción del gasto vinculado a la prescripción sin un incremento de costes de dispensación y podría reducir los stocks domiciliarios de aquellos medicamentos que objetivamente no es conveniente que sean aplicados sin un diagnóstico previo.OBJECTIVE To evaluate the economical impact of using medications packaged in a single dose non-reusable container (Onedose(®)), compared to prescribing preparations in the usual multidose containers. DESIGN We performed a cost-minimization analysis from a prescribing centers perspective. The observational study design is retrospective and analyzes 23 products in prescriptions made between January and April 2012. SETTING Two Spanish Primary Care Centers located in the province of Barcelona. The first covered an urban area with a population of 24.500 people, and the second a semi-urban area with 10.000 people. PRIMARY OUTCOME MEASURES Each examined product was measured between January and April 2012 and extrapolated annually, based on the defined substitution scenarios results of total Euro savings in non-prescribed doses and price differences. RESULTS The Savings related to the substitution of the prescribed packaging presentations with Onedose(®) were 45.000 Euros (24%) in the months of analysis and 133.000 Euros annually, avoiding the use of 212.000 doses (14%) in the period analyzed and 669.000 doses annually. CONCLUSIONS The use of single dose non-reusable container packaging (Onedose(®)) in the analyzed health centers reduced prescription-related expenses without increasing dispensing costs, thus reducing the household stock of those medicines which are not objectively suitable to be used without a previous diagnosis.