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Ruolo del farmacista ospedaliero nell’appropriatezza prescrittiva e nel contenimento della spesa farmaceutica sugli antibiotici ed antimicotici ad alto costo

DOI 10.23753/htafocus2017.01.006

Gaia Asaro, Barbara Bolletta, Andrea D’Alessio, Alessio De Luca, Vincenzo Mirabello, Lucia Pavan

Abstract

Introduction The controlled and efficient prescription dispensing, as well as the hospital cost-containment, are fundamental aspects of the role of the hospital pharmacist.
Recent studies have demonstrated that a methodical and efficient control over the prescription dispensing of high-cost antibiotics and antimycotics on a regional scale, ensures a cost-effective practice for the Italian national healthcare system. Such approach is also likely to maximise the positive outcome of the therapeutic treatment.
Hereby, we describe how an appropriate and efficient dispensing/administering of high-cost drugs, by the pharmacists working at the Pharmacy of the University Hospital “Agostino Gemelli” Polyclinic, can generate significant cost benefits for the Italian SSN.
Materials and methods From March 28th to May 31st 2016 an observational study has been carried out at the UOC Pharmacy. The prescriptions arrived at Pharmacy have been collected, and the data extrapolated and analysed. 2,298 prescriptions have been presented to the UOC Pharmacy. Such prescriptions were requested for 876 patients, resulting in an average of 2.62 prescription requests per person. The high-cost antibiotics requested and discussed hereby are as follows: meropenem; imipenem/cilastatin; ertapenem; linezolid; piperacillin/tazobactam; daptomycin; tigecycline. The high-cost antimycotics requested and discussed hereby are: liposomal amphotericin B; voriconazole; caspofungin; anidulafungin.
Results The 2,298 prescriptions overall represent 16,632 units of the aforementioned antibiotics and antimycotics. Only the 87% of the 16,632 units were approved by the hospital pharmacist. Particularly, daptomicin and anidulafungin are the medications that were denied the most. Such high-cost drugs were approved and administrated only in the 67% of the regional prescriptions. The pharmacoeconomic data indicated that the hospital pharmacist generated a saving of € 65,936.
Conclusions This study demonstrates that the hospital pharmacist is a highly specialized professional and his responsibilities are key aspects not only for the positive outcome of the therapeutic treatment, but also for generating a significant cost benefits for the healthcare community.

Key words: antibiotics, antimycotics, pharmacist, cost, healthcare

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