RESUMEN
Objective: Since January 2013, the national drug information center (NDIC) has started providing services and since December 2013, it is answering all the public and professional inquiries made through the Ministry of Health (MOH)-Hotline Calling Services (937). Therefore, in this study, we explored the cost avoidance analysis of national drug information inquiries by the hotline services in Saudi Arabia. Methods: We simulated the drug information inquiries related to the adults and children for the duration of 12 months of 2014 through MOH-hotline calling services (937). At least 10 on-call clinical pharmacists and expert trained pharmacists were receiving calls made from public and professionals inquiring about drug information. The data were collected in the drug information data collecting form through manual documentation system of drug information inquiries. Results: The drug information pharmacist implicated that the high-cost avoidance at the public side came from the dose standardization (30,310 USD (37.5%)) of the total cost avoidance followed by the drug administration and adverse drug reaction (16,532 USD (20.45%) and 9,347.5 USD (11.56%), respectively), which represent more than 50% of the total cost avoidance from the public side. With regard to professional inquiries, the drug information pharmacist implicated that the highest cost avoidance was through inquiries related to drugs in pregnancy, which was around 7,527.50 USD (26%) of the total cost followed by the drug administration, drug–drug interaction and drug identification (4,792 USD (16.5%); 4,141.50 USD (14.3%); and 4,135.50 USD (14.2%), respectively), which represent more than 50% of the total cost avoidance from the professional side. Conclusion: NDIC was the first in calculating cost avoidance from answering drug information inquiries from professional and public separately in the Middle Eastern countries. It is highly implicated in the drug information services in the healthcare organization in the Kingdom of Saudi Arabia.
RESUMEN
Background: Screening approved medications to identify therapeutics for drug repurposing is an effective tactic, and a deep research into off label drug use (OLDU) is required. Unfortunately, OLDU has not been extensively studied in Middle East. Our study aimed to evaluate the extent of OLDU in Saudi Arabia.Methods: Retrospective study carried out during 12 month period at six tertiary hospitals in Saudi Arabia. Each prescription was evaluated as unlicensed or OLDU based on the product information or based on Food and drug Administration (FDA) approval.Results: A total of 288 prescriptions were analyzed, where the reasons for off-label prescribing were OLDU by indication (94.42%), OLDU by different age group (2.09%), and other reasons represented (3.48%). Adults/geriatrics (≥18 years) received (89.05%) of the orders, and children (1-11 years) received (7.78%) of the orders. Both adolescents (12-18 years) and neonates (1-29 days) received (1.42%) of the orders per each category, while infants (1 month-1 year) received (0.36%) of the orders. The therapeutic classes most often prescribed were antidepressants (21.88%), antidiabetics (17.71%), and atypical antipsychotics (10.06%).Conclusions: Off-label prescribing was found in most adults/geriatrics suffering from depression, and diabetes mellitus. The most common reason for off-label prescription was off-label by indication. The results call for the need to conduct more studies with larger sample size, do more investigations on the OLDU in the whole kingdom, and develop policy for OLDU across hospitals.