Background and importance There are drugs that should be avoided despite authorisation by agencies. Can we justify drugs with no proven efficacy or relevant clinical outcomes? Prescrire (non-profit organisation, IF: 0.18) publishes an annual review of drugs to avoid. They identified 105 drugs that cover studies between 2010 and 2019. Drugs with a better harm–benefit balance are available in most of cases.
Aim and objectives To analyse and check our pharmacotherapeutic guide (PG) according to the 2020 Prescrire’s review.
Material and methods We evaluated the 2020 annual review of drugs to avoid from Prescrire’s and its concordance with a PG of a level II hospital and the impact of use and cost versus alternatives available, between January and August 2020. Information was collected from Farmatools software and the Prescrire’s review. Data recollected were: drugs and Prescrire’s alternative proposal included in the PG; use (defined daily dose (DDD)) and cost of the drugs of Prescrire’s included in the PG and the alternatives and the entire PG.
Results 105 drugs were studied. 23 were in the PG (21.9%), 15 with a guaranteed better choice, all of them in the PG (100%). 2 of 23 (trabectedin, vinflunine) had any use. 20 of 23 had 8592 DDD, 5421.8€ versus 1 507 871 DDD, 110 327€ in 13/15 alternatives. 1 of 23 (teriflunomide) had 4580 DDD, 132 179€ versus 1907 DDD, 184 296€ for the alternative (IFN-β). Global PG use was around 14 000 000€. 82 drugs were not in the PG (78.1%). 60 of them had better harm–benefit alternative; 58 (96.7%) were in our PG.
Conclusion and relevance Our study showed that our PG was well adapted according to Prescrire’s recommendations. The presence of drugs to avoid was low, the majority because their use was well established in clinical practice or are reserved for very specific situations. The global impact (without teriflunomide) in total cost and use was worthless. Our next step is to re-evaluate the results and make a better PG, with a special focus on teriflunomide (currently has a strong follow-up) and minimise the use of those essential to the physician in very specific situations. It is possible to conclude that our PG, developed by hospital pharmacists in a multidisciplinary team, guarantees quality, safety and efficiency.
References and/or acknowledgements
Towards better patient care: drugs to avoid in 2020. Prescrire Int 2020;29(212):51–1–51–10.
Conflict of interest No conflict of interest