HOSPITAL PHARMACIST IN CHARGE OF EXPENSIVE MEDICINES – REDESIGN OF THE PROCESS
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European Statement
Clinical Pharmacy Services
Why was it done?
Expenditure on medicines is increasing, mainly due to the availability of expensive, innovative medicines. The admission process for expensive medicines to the Dutch market is complicated and available medicines are not always (fully) reimbursed.
At the Martini Hospital, many different parties were involved in the expensive medicines file. However, mutual coordination was limited and there was a lack of direction, monitoring and feedback of information to the prescribers.
What was done?
In collaboration with all parties involved, the process for expensive medicines has been redesigned, from application to monitoring and feedback of information to the prescribers. Responsibilities for parts of the process have been explicitly assigned and a hospital pharmacist is in charge of the process.
How was it done?
Various sub-processes have been defined: contracting, prescription and distribution, screening for new substances/indications, financial handling and monitoring. Tasks and responsibilities have been identified for each process and it has been determined how monitoring takes place.
A digital procedure for applying for new expensive medicines or indications, compassionate use programs and authorizations for individual patients has been developed.
Specific reports have been developed for each group of prescribers and are sent periodically. These reports include, for example, compliance with agreements made about preferred substances, conversion to biosimilars, and correct completion of indication codes (which are required for reimbursement).
What has been achieved?
A clear method for requesting new expensive medicines or indications has been implemented. The average processing time for a new application has decreased significantly (exact figures will be available during the EAHP 2025)
All information regarding reimbursement of expensive medicines is centrally available and transparent to all parties involved.
Physicians’ awareness and knowledge of expensive medicines has increased, and this is reflected in their prescribing behavior.
The amount of unreimbursed medicine costs has been substantially reduced (exact figures will be available during the EAHP 2025)
What next?
Continuous evaluation of the process and further development of the reports to the prescribers.