Cost-effectiveness of drug therapy prescribed in special situations at hospital

The Pharmacy and Therapeutics Committee is an advisory body to  the medical management of our hospital. Following Royal Decree 86/2015,  which regulates the Pharmacy and Therapeutics Committee of the Balearic  Islands, this committee prepared a technical report in which it assessed the  possible internal use of off-label drugs, drugs for compassionate use, and drugs  not included in the hospital's pharmacotherapeutic guide. The objective was to  analyse the clinical response achieved with the use of these drugs and their  associated costs.

Retrospective study of drugs whose use was requested from the  hospital's Pharmacy and Therapeutics Committee hospital between January and  December 2018. We analysed whether the requested treatment achieved the  objective established by the physician. The cost was calculated based on the  duration of the treatment until the objective was achieved or until treatment was discontinued.

In total, 70 requests were analysed: 59% achieved the expected therapeutic goal, 34% were considered to be therapeutic failures, and  7% were lost to follow-up. The overall cost of the 70 authorized treatments was  €1,140,240. The average cost per request was €16,288. Oncology and  Haematology services submitted more than 50% of the requests, and more than 75% of the budget was allocated to these medical services.

More than half of the treatments analysed by the Pharmacy and  Therapeutics Committee of the hospital achieved their therapeutic goal, although the economic cost of their use was high.