Evaluación del impacto de la utilización de medicamentos en dosis unitarias en 2 centros de atención primaria / Assessment of the impact of the use single-dose medications in 2 primary care centres

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.EmplazamientoEl 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 (AU)

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 center’s 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 (AU)

Immunogenicity, reactogenicity and safety of an inactivated quadrivalent influenza vaccine candidate versus inactivated trivalent influenza vaccine: a phase III, randomized trial in adults aged ≥18 years.

BACKGROUND: Two antigenically distinct influenza B lineages have co-circulated since the 1980s, yet inactivated trivalent influenza vaccines (TIVs) include strains of influenza A/H1N1, A/H3N2, and only one influenza B from either the Victoria or Yamagata lineage. This means that exposure to B-lineage viruses mismatched to the TIV is frequent, reducing vaccine protection. Formulations including both influenza B lineages could improve protection against circulating influenza B viruses. We assessed a candidate inactivated quadrivalent influenza vaccine (QIV) containing both B lineages versus TIV in adults in stable health. METHODS: A total of 4659 adults were randomized 5:5:5:5:3 to receive one dose of QIV (one of three lots) or a TIV containing either a B/Victoria or B/Yamagata strain. Hemagglutination-inhibition assays were performed pre-vaccination and 21-days after vaccination. Lot-to-lot consistency of QIV was assessed based on geometric mean titers (GMT). For QIV versus TIV, non-inferiority against the three shared strains was demonstrated if the 95% confidence interval (CI) upper limit for the GMT ratio was ≤1.5 and for the seroconversion difference was ≤10.0%; superiority of QIV versus TIV for the alternate B lineage was demonstrated if the 95% CI lower limit for the GMT ratio was > 1.0 and for the seroconversion difference was > 0%. Reactogenicity and safety profile of each vaccine were assessed. Clinicaltrials.gov: NCT01204671. RESULTS: Consistent immunogenicity was demonstrated for the three QIV lots. QIV was non-inferior to TIV for the shared vaccine strains, and was superior for the added alternate-lineage B strains. QIV elicited robust immune responses against all four vaccine strains; the seroconversion rates were 77.5% (A/H1N1), 71.5% (A/H3N2), 58.1% (B/Victoria), and 61.7% (B/Yamagata). The reactogenicity and safety profile of QIV was consistent with TIV. CONCLUSIONS: QIV provided superior immunogenicity for the additional B strain compared with TIV, without interfering with antibody responses to the three shared antigens. The additional antigen did not appear to alter the safety profile of QIV compared with TIV. This suggests that the candidate QIV is a viable alternative to TIV for use in adults, and could potentially improve protection against influenza B. TRIAL REGISTRATION: Clinical Trials.gov: NCT01204671/114269.

[Assessment of the impact of the use single-dose medications in 2 primary care centres]. / Evaluación del impacto de la utilización de medicamentos en dosis unitarias en 2 centros de atención primaria.

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 center's 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.