Background Romiplostim is indicated for the treatment of primary immune thrombocytopenia (ITP) in adult patients who are refractory to other treatments (corticosteroids, immunoglobulins). This drug has an important economic impact, in this sense it has been decided to start a protocol for the use of romiplostim which has been established to group patients or dispense two repackaged romiplostim pre-filled syringes for each patient fractionating vials according to the patient´s dose in syringes as a saving strategy.

Objective Evaluating and quantifying the cost saving of the optimisation of the use of romiplostim vials through repackaging into syringe under aseptic conditions.

Material and Methods Retrospective study from January to June 2023 and patients diagnosed from ITP and treated with romiplostim were included. A protocol is being implemented, which consists of dispensing two repackaged romiplostim pre-filled syringes (7 days expiration according to Good Practice Guide of preparation of medications in hospital Pharmacy Service) for each patient or grouping the patients receiving treatment with romiplostim and fractionating the vial in syringes to adjust to the recommended dose according to the Summary of Product Characteristics in a flow laminar cabinet. Variables collected: demographics (sex/age), number of patients, and economic (price of romiplostim vial). Data were collected from pharmacy electronic dispensing records.

Results A total of 16 patients suffering from ITP are being treated in our hospital with romiplostim, 50% of them are men, and median age 54 years old (21–90). This treatment has cost a total of €240,561.95 for these 6 months (January to June), however, if patients had been dispensed two repackaged romiplostim pre-filled syringes or had been grouped and given appointment on the same of the week and romiplostim repackaging had been performed under aseptic conditions, the total cost had been €158191,48 therefore the cost saving there would been €82.370,47 (€164.740,94/year).

Conclusion and Relevance The dispensing of two romiplostim pre-filled syringes or the grouping of patients and the fractionation of romiplostim vials would suppose a saving of €164.740,94 (saving of 86.342,21 mcg romiplostim, 345 vials of 250 mcg) every year. The repackaging could represent a significant economic saving in the treatment of idiopathic thrombocytopenic purpura, while contributing to maintaining the sustainability of the national health system.

References and/or Acknowledgements No-conflict-of-interest

Conflict of Interest No conflict of interest.