ABSTRACT
Objetivo: Los servicios de farmacia hospitalaria se han adaptado a lapandemia de COVID-19. El objetivo del estudio es determinar las consecuencias económicas de sustituir la dispensación de medicamentos en elservicio de farmacia hospitalaria por otros métodos de dispensación enel contexto de los tratamientos biológicos para la psoriasis en España.Método: Se evaluaron múltiples escenarios de dispensación, combinando diferentes frecuencias y lugares de dispensación, y frecuencias delseguimiento de telefarmacia. Se incluyeron los medicamentos biológicosautoinyectables para la psoriasis (inhibidores de interleucinas y del factorde necrosis tumoral alfa). Todos los costes (euros de 2020) se consideraron desde la perspectiva del Sistema Nacional de Salud.Resultados: Considerando la dispensación en la farmacia hospitalaria, la frecuencia de dispensación cada 4 semanas y la telefarmacia encada administración, el coste anual de dispensación por paciente oscilóentre 194,9 y 2.088,0 . En los diferentes escenarios simulados, losfármacos biológicos que se asociaron a un coste inferior fueron los quese administran de forma más espaciada en el tiempo (cada 12 semanas).Conclusiones: En la era post-COVID-19, los nuevos modelos de atenciónfarmacéutica hospitalaria que consideran cambios en la dispensación farmacológica y la telefarmacia tendrán consecuencias económicas para elSistema Nacional de Salud que merecen consideración. (AU)
Objective: Hospital pharmacy services have adapted to the COVID-19pandemic. The aim of the study is to determine the economic consequences of replacing hospital pharmacy dispensation with other dispensingmethods in the context of biological treatments for psoriasis in Spain.Method: Multiple dispensation scenarios were evaluated, combiningdifferent dispensation frequencies and sites, and telepharmacy followup intervals. Self-injectable biological medicines for psoriasis (interleukinand tumour necrosis factor alpha inhibitors) were included. All costs(in 2020 euros) were considered from the perspective of the NationalHealth System.Results: The annual cost of hospital pharmacy-based dispensationsevery 4 weeks combined with telepharmacy monitoring at each administration ranged from 194.9 to 2,088.0 per patient. Across the differentsimulated scenarios, biological medicines associated with the lowest costwere those administered less frequently (every 12 weeks).Conclusions: In the post-COVID-19 era, new models of hospital pharmaceutical care that include changes in drug dispensation and telepharmacy strategies will have economic consequences for the National HealthSystem that merit consideration. (AU)
Subject(s)
Humans , Delivery of Health Care , Psoriasis , Biological Therapy , TelemedicineABSTRACT
OBJECTIVE: Hospital pharmacy services have adapted to the COVID19 pandemic. The aim of the study is to determine the economic consequences of replacing hospital pharmacy dispensation with other dispensing methods in the context of biological treatments for psoriasis in Spain. METHOD: Multiple dispensation scenarios were evaluated, combining different dispensation frequencies and sites, and telepharmacy followup intervals. Self- injectable biological medicines for psoriasis (interleukin and tumour necrosis factor alpha inhibitors) were included. All costs (in 2020 euros) were considered from the perspective of the National Health System. RESULTS: The annual cost of hospital pharmacy-based dispensations every 4 weeks combined with telepharmacy monitoring at each administration ranged from 194.9 to 2,088.0 per patient. Across the different simulated scenarios, biological medicines associated with the lowest cost were those administered less frequently (every 12 weeks). CONCLUSIONS: In the post-COVID-19 era, new models of hospital pharmaceutical care that include changes in drug dispensation and telepharmacy strategies will have economic consequences for the National Health System that merit consideration.
Objetivo: Los servicios de farmacia hospitalaria se han adaptado a la pandemia de COVID-19. El objetivo del estudio es determinar las consecuencias económicas de sustituir la dispensación de medicamentos en el servicio de farmacia hospitalaria por otros métodos de dispensación en el contexto de los tratamientos biológicos para la psoriasis en España.Método: Se evaluaron múltiples escenarios de dispensación, combinando diferentes frecuencias y lugares de dispensación, y frecuencias del seguimiento de telefarmacia. Se incluyeron los medicamentos biológicos autoinyectables para la psoriasis (inhibidores de interleucinas y del factor de necrosis tumoral alfa). Todos los costes (euros de 2020) se consideraron desde la perspectiva del Sistema Nacional de Salud.Resultados: Considerando la dispensación en la farmacia hospitalaria, la frecuencia de dispensación cada 4 semanas y la telefarmacia en cada administración, el coste anual de dispensación por paciente osciló entre 194,9 y 2.088,0 . En los diferentes escenarios simulados, los fármacos biológicos que se asociaron a un coste inferior fueron los que se administran de forma más espaciada en el tiempo (cada 12 semanas).Conclusiones: En la era post-COVID-19, los nuevos modelos de atención farmacéutica hospitalaria que consideran cambios en la dispensación farmacológica y la telefarmacia tendrán consecuencias económicas para el Sistema Nacional de Salud que merecen consideración.
Subject(s)
Biological Products , COVID-19 , Pharmaceutical Preparations , Psoriasis , Humans , Pandemics , Psoriasis/drug therapy , SARS-CoV-2 , SpainABSTRACT
INTRODUCTION: Approximately 4% to 8% of patients with HIV-1 treated with abacavir present a hypersensitivity reaction (HSR). Various studies have shown a direct association between human leukocyte antigen (HLA)-B*5701 and HSR to abacavir. The objective of this study was to analyze whether systematic HLA-B*5701 testing to prevent HSR in patients treated with abacavir is a cost-effective option for the Spanish National Health System. METHODS: An analytical decision-making model was constructed as a decision tree model for a simulated cohort of 1000 HIV patients to evaluate whether HLA-B*5701 testing to prevent HSR to abacavir was cost effective compared with not performing the test. The parameters included in the model and the use of healthcare resources should the patient develop HSR were taken from the PREDICT-1 study and the opinion of clinical experts. The principal result obtained was the incremental cost per HSR avoided. The time horizon of the analysis was to 2 months [corrected] . All costs were expressed in 2008 Euros. RESULTS: The analysis showed that the total direct healthcare costs per patient were 1344 and 1322 with and without HLA-B*5701 testing respectively, and that 36 cases of HSR were prevented per 1000 screened patients. These results yielded a cost per HSR avoided of 630. The sensitivity analysis showed that the results were sensitive to the cost of the test, with an economic saving of 102 or a cost-effectiveness ratio of 4234. CONCLUSIONS: The model predicts that generalized use of the HLA-B*5701 test before prescribing abacavir in HIV+ patients could represent an economic saving or a limited additional cost for the National Health System which may be counterbalanced by the benefits in terms of a lower incidence of HSR.
