Article Text
Abstract
Background and importance The study, launched in November 2018 and still ongoing, was conducted by the ophthalmology department and the hospital pharmacy, involving all patients undergoing treatment with ranibizumab. This collaboration included weekly meetings, during which pharmacists presented data relating to the therapies and discussed problems encountered.
Aim and objectives We started this retrospective prospective study about ophthalmic treatments to verify any non-refunds or incorrect prescriptions and to guarantee a better allocation of available resources and prescriptive appropriateness.
Material and methods We created an Excel file to compare data extracted from AIFA’s registers and medical records, and to verify the correct request for reimbursement of prescribed treatments.
Results 400 prescriptions were paper based (not web based as should be the case) with no AIFA registration. Use of paper based AIFA requests: failure to register the new therapy in patients already signed in for other diseases or drugs, failure to transfer four patients from other centres. Of 179 patients treated, 175 dispensations were identified and registered ex novo, involving: 43 requests for reimbursement (obtained from paper based requests), registration of four patients and inclusion of six previously unsolicited treatments. During meetings, incorrect data from a few patients emerged (personal data or treated eye) with consequent correction in six medical records and registers. All folders were registered on the AIFA platform with consequent request of 43 refunds as payment by result, equal to 26 337 586€ (1 531 255€ derived from 25 dispensing requests not previously made and emerged because of the retrospective control carried out in November 2019).
In the Official Gazette No 45 (23 February 2017), a capping agreement was introduced, for each eye, of a refund of the drug’s cost following the seventh treatment in naïve patients. The team agreed to continue monitoring prescriptions and this resulted in a saving of about 40 500€ from the request for 90 refunds as a bonus. On 8 October 2019, the AIFA introduced a simplified multi-drug monitoring register so the pharmacist does not have to dispense drugs and there are no refunds.
Conclusion and relevance Collaboration between clinicians and pharmacists is ongoing, monitoring the correct transfer of patients from the old to the new register. It can be concluded that a figure dedicated to the management of drugs can guarantee clinical and economic drug administration, ensuring greater appropriateness and better allocation of resources.
Conflict of interest No conflict of interest