PC2 – Compounding without frontiers, cooperation over country borders

Link to EAHP Statements

• Section 1 – Introductory Statements and Governance: Statements – 1.2, 1.3
• Section 2 – Selection, Procurement and Distribution: Statements – 2.5, 2.6
• Section 3 – Production and Compounding: Statements – 3.1, 3.2, 3.3, 3.4, 3.5, 3.6
• Section 5 – Patient Safety and Quality Assurance: Statements – 5.6, 5.10

Abstract

During times of limited resources, both in terms of personnel and materials, any initiatives that lead to the optimisation of available resources are highly advisable.

A clear division has been observed between new and “sometimes” innovative medications, which are readily available, and older, typically cheaper medications that, despite their usefulness, are frequently subject to drug shortages. When an essential medication is not available on the market, the hospital pharmacist is the only professional with the necessary drug manufacturing knowledge to prepare it within the hospital. Depending on the degree of complexity in its manipulation, there may be hospital pharmacies without the necessary conditions for manufacturing such medications, especially in sterile compounding. In these situations, the possibility of organisation between hospitals is already a reality, which varies greatly from country to country.

Cooperation over country borders can help to improve the quality assurance and quality improvement of compounded drugs used in hospitals. When hospitals collaborate with other institutions and organisations across borders, they can benefit from a wider range of expertise and resources. For example, hospitals can share information about the best practices for compounding medications, as well as the latest research and developments in the field, in an interprofessional collaborative practice. They can also share resources, such as specialised equipment and facilities, to ensure that compounded drugs are produced safely and effectively. This might be crucial particularly in the production of drugs that are in short supply, not commercially available, or in cases of allergies to a specific ingredient in a commercial medication.

Besides the European Association of Hospital Pharmacists (EAHP), other internationals associations are promoting compounding safety standards and guidelines, as the Alliance for Pharmacy Compounding in U.S. or the Canadian Hospital Pharmacy Compounding Collaborative. The European Commission EU4Health programme 2021-2027 has a financial incentive for cross-border collaboration and partnerships to strengthen European health systems. The Council of Europe Resolution states that “Collaboration between national authorities, professional bodies and intergovernmental organisations should therefore be strengthened to continue to develop and share harmonised standards and best practices for the safety and quality of the process of medication use”.

Learning objectives

After the session, the participant should be able to:

• Understand cooperation over country borders initiatives
• Recognize the European policies related to drug shortages
• Promote a regional or cross-country networking for compounding

Educational need addressed

Motivation to optimise compounding, facing drug shortages and limit the dependency on imports of medicines and active pharmaceutical ingredients from non-EU countries, in a more environmentally friendly production with respect to the European Medicines Agency and European Commission resolutions.

Keywords

Compounding, cross-border cooperation in healthcare, drug shortages, environmental sustainability