Background Structured and commented reviews (SCREVs) are individual assessments for drugs not included in the Pharmacotherapeutic Guide (NIPG) and off-label drugs requested by prescribers, in order to approve their use.

Purpose To describe the SCREVs performed and to estimate the financial impact of the pharmacy recommendations.

Material and methods A three-year retrospective descriptive study was designed with SCREVs performed in this period. SCREVs contained information about indications (NIPG or off-label), efficacy, safety, convenience, costs, including alternatives and cost/utility analysis, with a limit of €40,000/QALY. The final pharmacy recommendation included A (approval), B (conditional approval), C (refusal) or D (non-opposition with negative opinion). In case C the savings achieved using the average treatment time were estimated. In case D the effectiveness and the financial impact associated with the use of the drug were calculated.

Results 48 SCREVs were analysed: 17 off-label and 31 NIPG. The highest number of requests came from Oncology (48%). The pharmacy recommendations were: 16.6% A, 54.2% B, 18.75% C and 10.45% D.

The savings achieved with recommendation C were €229,324. The financial impact of recommendation D (all of them offered to the patients before request) was €63,447. Their effectiveness measured by overall survival (OS) and progression-free survival (PFS) were OS < 2 months, PFS < 5 months in all cases.

Conclusion Individual SCREVs were useful for taking complicated decisions about off-label and NIPG drugs use at the hospital, with important savings achieved. More than half of the drugs requested were approved with adjusted conditions of use. The cases with negative pharmacy opinions showed low effectiveness.

References and/or Acknowledgements Authors

No conflict of interest.