Background High economic impact medicines are used off-label in paediatric situations, using adult presentations for lack of a paediatric form.
Purpose To justify preparing individualised medicines for paediatric use according to individual need; adaptation to increase safety and reduce costs.
Materials and Methods Retrospective review of high-impact medicines used in individualised treatment in paediatrics. Duration of study: 4 years. The medicines were included if they had been needed (adalimumab 35 months, anakinra 73 months and pegfilgrastim 50 months).
Data collection sources: Computer application in the pharmacotechnical area, software of the outpatient dispensing and management system. Personnel times were collected according to the Catalogue of Products and Billing (2nd edition 2009) and costs according to the Analytical Accounting Service. As these were standard sterile formulas the time and cost of pharmaceutical personnel were considered (standard operating procedure of a new product and successive validations), nurse (production) and technician (material preparation, labelling and packaging.
We compared the cost of dispensing the complete pharmaceutical form with individualised costs through sterile repackaging.
Variables studied: patients, different types of dosages, number of syringes made, number of syringes consumed and associated costs. For economic valuation the cost of the commercial presentation and the personnel involved in the making were considered.
Results The 3 medicines identified were repacked from the adult branded product formulations.
The results are expressed in the above table:
Conclusions Individualization of dosage represents both an optimization of resources and increased patient safety. Repackaging improves difficult-to-measure volume management, avoiding handling in unsuitable conditions by the patient.
No conflict of interest.
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