Cost-effectiveness of drug therapy prescribed in special situations at hospital

Abstract

Objective: The Pharmacy and Therapeutics Committee is an advisory body to the medical management of our hospital. Following Royal Decree 86/2015, which regulates the Pharmacy and Therapeutics Committee of the Balearic Islands, this committee prepared a technical report in which it assessed the possible internal use of off-label drugs, drugs for compassionate use, and drugs not included in the hospital’s pharmacotherapeutic guide. The objective was to analyse the clinical response achieved with the use of these drugs and their associated costs. Method: Retrospective study of drugs whose use was requested from the hospital’s Pharmacy and Therapeutics Committee hospital between January and December 2018. We analysed whether the requested treatment achieved the objective established by the physician. The cost was calculated based on the duration of the treatment until the objective was achieved or until treatment was discontinued. Results: In total, 70 requests were analysed: 59% achieved the expected therapeutic goal, 34% were considered to be therapeutic failures, and 7% were lost to follow-up. The overall cost of the 70 authorized treatments was €1,140,240. The average cost per request was €16,288. Oncology and Haematology services submitted more than 50% of the requests, and more than 75% of the budget was allocated to these medical services. Conclusions: More than half of the treatments analysed by the Pharmacy and Therapeutics Committee of the hospital achieved their therapeutic goal, although the economic cost of their use was high.

Keywords

• pharmacy and therapeutics committee
• pharmacotherapeutic guide
• off-label use
• compassionate use trials
• assessment studies
• clinical audit
• outcome and process assessment
• health care