Ejhp Practice 

Abstract: Aim: To evaluate the financial impact of three different preparation and conservation scenarios for cytotoxic drugs. Method: In scenario one we discarded the residual fraction of the drug after each preparation. In scenario two we used the residual fraction of the vial until the end of the day. In scenario three we used the residual fraction of the vial until the chemical/physical expiry date. To analyse the economic impact of the three scenarios, we looked at 3,086 preparations during July and August 2006. Results and discussion: A major difference in cost was found between the three scenarios, namely: Euros 872,413, Euros 807,309 and Euros 754,442 for scenarios one, two and three respectively. Savings varied between a minimum of Euros 52,867 (7%) and a maximum of Euros 117,971 (15%) for the observation period of two months, or an average of Euros 17 to Euros 38 per preparation. Conclusion: When cytotoxic medicines are prepared under rigorous conditions, pharmacists can contribute to substantial economic savings.

Abstract: Study objectives: The Drug and Therapeutics Committee (DTC) has an essential role in managing the pharmacotherapeutic policy of a hospital. Because the formulary is a guide for appropriate drug selection and a tool for supporting the quality of drug use and cost control, it should be complete, concise and easy to use. The purpose of this study was to evaluate the format, organisation and content of formularies used in Belgian hospitals. Indicators, proposed on the basis of a literature review, were evaluated for validity, clarity and accessibility by two senior and five junior pharmacists. The selected indicators were classified in five groups: technical features, user-friendliness, information on drug procedures, product specific information and guidelines. Points were assigned to each indicator, according to their importance, to give a total of 1,000 points. The formularies were evaluated based on this model. Results: Seventy-three Belgian hospital formularies were evaluated. A current list of the medicines available in the formulary was presented by 69% of the hospitals. A minority of these (24%) were presented in a pocket format. Only a few formularies mentioned the objectives, tasks and constitution of the DTC. Four formularies (5%) contained guidelines for empirical treatment of infections. The quality of the majority of the formularies, according to the predefined indicators, was poor, with a mean of 145 points out a possible total of 1,000. Conclusion: The evaluation of 73 Belgian hospital formularies showed that their quality varies and should be enhanced in order to serve its target groups better.