The EAHP Board, elected for three-year terms, oversees the association’s activities. Comprising directors responsible for core functions, it meets regularly to implement strategic goals. Supported by EAHP staff, the Board controls finances, coordinates congress organization, and ensures compliance with statutes and codes of conduct.
Horizon Scanning in Denmark: Providing the health care system with an overview and impact estimation of new medicines
European Statement
Selection, Procurement and Distribution
Author(s)
Helle Brauner
Why was it done?
There was a need for improved planning and preparing processes, as when it comes to price negotiations and estimates on financial burden and strategic procurement.
What was done?
Amgros, a part of the Danish health care system, has secured the supply of medicines and hearing aids to public hospitals and hearing clinics across Denmark for 30 years. This is done through efficient procurement and tendering procedures, creating economies of scale and savings.
In addition to this, in January 2017, Amgros launched its own Horizon Scanning unit. Now, the Danish Horizon Scanning system provides the health care system with an overview of medicines, indications and extensions e.g. pharmaceutical forms expected to be entering the Danish market within the next 2-3 years.
How was it done?
In 2016, it was decided to establish an Horizon Scanning system in Denmark. Then, input from internal and external stakerholders regarding their needs and expectations were gathered.
The outputs from the Horizon scanning unit consist of an overview of medicines about to reach the Danish market, as well as estimates of costs for new, expensive medicines and possible savings, for example if there are cheaper biosimilar drugs on the market. We also assess potential patient population and location of treatment. This is done in close cooperation with several Danish clinicians.
Sources for verifying and validating the data inputs are primarily EMA, complemented with commercial databases and a niche group of other sources. Data is gathered in a database.
What has been achieved?
The outputs enable our stakeholders to better plan the introduction of new medicines, to secure more cost-effective health solutions for everyone and to achieve more health for money in the Danish hospital setting.
Danish Regions, the interest organization for the health care regions, use the estimates in their annual negotiations with the Government on finances and the individual regions use them in their own budgets.
The predictability this system brings to Denmark is key in a future with more rare diseases, treatments and advanced pricing.
What next?
The Horizon scanning function is continuously being developed to meet the needs of our stakeholders, as we want to enable them in providing health care to the Danish citizens.
CAN THE CLINICAL PHARMACIST INCREASE HOSPITAL STAYS’ PRICING? (submitted in 2019)
European Statement
Clinical Pharmacy Services
Author(s)
Thibault Stala, Niels Martignene, Céline Monchy, Anne-Laure Lefebvre, Geoffrey Strobbe, Ali Hammoudi, Frédéric Feutry, Malgorzata Cucchi, Guillaume Marliot
Why was it done?
In France, hospitalisations’ reimbursement is linked to care severity. In this context, health care must be as comprehensive as possible on the comorbidities’ registration. As part of prescription validation, the clinical pharmacist can easily highlight comorbidities associated with specific treatments, in order to improve their codification and consequently to better valorise hospital stays.
What was done?
This work involves evaluating the ability of the clinical pharmacist to detect comorbidities related to certain treatments.
How was it done?
Six comorbidities, associated with the prescription of specific therapies, were chosen: – Dyskalaemia (potassium or polystyrene sulfonate prescriptions); – Neuropathic pain (NP) or anxio-depressive disorder (ADP) (amitriptyline, anafranil, pregabalin, gabapentin, duloxetine or capsaicin prescriptions); – Iron deficiency anaemia (IDA) (injectable iron prescriptions); – Hypovolaemia (HV) (ringer Lactate, serum albumin or gelatin prescriptions); – Hypercalcaemia (HC) (bisphosphonate and/or calcitonin prescriptions); – Severe infection (Inf) (linezolid, daptomycin, teicoplanin, aztreonam and carbapenem prescriptions). Retrospectively, all stays ending between 01/01/2019 and 31/03/2019, and containing at least one prescription of the previously mentioned therapies, were considered. Then, the medical records were analysed to verify the presence of the comorbidity corresponding to the prescribed drug(s). The coding was checked, otherwise, the comorbidity was added. Finally, the revaluation of the stays’ cost has been estimated.
What has been achieved?
The number of stays by suspected comorbidity, based on prescribed treatments, is : – 175 dyskalaemia; – 231 NP or ADP; – 155 IDA; – 124 hypovolaemia; – 41 hypercalcaemia; – 16 severe infection hypovolaemia and severe infection were quickly set apart because of the difficulty to confirm these comorbidities with the only retrospective medical record information. No stay with IDA or hypercalcaemia has been revalorised. The price of a single stay with dyskalaemia has been increased, by €530. However, NP or ADP has increased the cost of 6 to 13 stays, resulting in a total revaluation of €6000 to €11,000.
What next?
The stays’ remuneration is the hospitals’ main source of income. This work makes it possible to quickly determine if the clinical pharmacist can bring added value in the field of hospital stays’ pricing. The next step is the transition to forward looking. It would also be possible to assess other comorbidities.
TASK FORCE TO FACILITATE THE INTRODUCTION OF BIOSIMILAR MEDICINES NATIONALLY: THE CASES OF INFLIXIMAB AND ETANERCEPT
European Statement
Selection, Procurement and Distribution
Author(s)
Karina Bentzen
Why was it done?
Introducing biosimilar medicines in the clinical setting may significantly reduce hospital medicines expenditure – but only if the biosimilar medicines are used. Lack of knowledge and insecurities about biosimilar medicines among healthcare professionals and patients must to be addressed to ensure implementation in the clinical setting.
What was done?
To facilitate the introduction of biosimilar medicines in Denmark, a special Taskforce was appointed. The aim was to enhance knowledge of biosimilar medicines among healthcare professionals and prepare implementation of biosimilar medicines in the clinical setting.
How was it done?
A special “Taskforce for introduction of biosimilars” was appointed. The Taskforce consisted of physicians including clinical pharmacologists, pharmacists, drug tender specialists and staff from the “Council for the Use of Expensive Hospital Drugs”, who issue national treatment guidelines.
Planning the introduction of biosimilar infliximab in Denmark started more than a year prior to the granting of marketing authorization. During this time, the Taskforce arranged seminars and facilitated meetings with specialists from the clinical setting to provide knowledge of biosimilars, to discuss the introduction of biosimilar medicines and how to switch patients. Based on these discussions the “Council for the Use of Expensive Hospital Drugs” dictated the use of biosimilar medicines nationally.
The Taskforce also created educational materials for doctors, nurses and patients and a “Q & A” website.
What has been achieved?
Biosimilars were adopted into the Danish market after a very quick introduction. The market share of the biosimilars was 95% within 3-4 months.
The price reduction after introducing biosimilar medicines was approx. 60%, and the quick implementation of the drugs in the clinical setting has significantly reduced medical costs.
Total annual savings in Denmark: 22 mio € (infliximab) and 15 mio €* (etanercept. * Estimate based on the first 6 months).
What next?
More new biosimilar medicines are expected to be introduced into the Danish market in the near future. The Taskforce will continue their work to ensure similar successful implementations.