Suchergebnisse

Objective: To evaluate whether collagenase injections would be a cost-effective alternative to surgery for Dupuytren's contracture in Malta. Method: An average of fifty patients per year requires surgery to correct Dupuytren's contracture in Malta. The price of collagenase injections was obtained from published pharmacoeconomic studies in Spain, United Kingdom and United States. The cost to treat multiple affected joints using collagenase injections at the different prices was compared to the costs associated with surgery in both the government and private hospital setting. A proposed price at which collagenase injections would be more costeffective than surgery to treat two affected joints in Malta was calculated. Key findings: The cost of surgery in the private hospital setting is significantly higher than that in the government hospital setting. The price of collagenase in the United States is significantly higher than in Europe. At the prices available in Europe, collagenase use in Malta would not confer significantly increased costs when treating one, two or three affected joints, both in the government and private hospital setting. Treating two affected joints rather than one affected joint does not significantly increase costs, however treating three affected joints significantly increases costs, in both hospital settings. For collagenase injections to be cost-effective in Malta, they would need to be priced at 77 Euro per vial or less. Conclusion: If all patients were to be administered the injection instead of undergoing surgery, the hospital would be able to accommodate 20 additional total knee replacements each year. With surgery costs in Malta being much less than in other European countries, there could be a possibility for Malta to attract patients from other countries. Collagenase injections would offer a less invasive treatment for the patients, and if priced at 77 Euro per vial or less, would provide a more cost-effective option to the government hospital. ; peer-reviewed

Objective: To give an insight into the financial impact of the Pharmacy Of Your Choice (POYC ) scheme on community pharmacies. Method: A time and motion study was carried out in three community pharmacies that are enrolled in the POYC scheme to provide information on the time allocated to the various activities pertaining to the scheme. Two different methods were used to calculate the costs incurred to implement the system in the three pharmacies. Key findings: The direct costs that are related to the implementation of the POYC scheme are reasonably close to the government's remuneration. Conclusion: Expenses incurred due to the POYC scheme run into thousands of Euro every year. Consequently, the POYC scheme does not seem to be very profitable for the community pharmacies where it has been implemented. It is highly recommended that the remuneration by the government ought to be revised. ; peer-reviewed

Objective: To analyse the introduction of reference pricing systems for pharmaceuticals in Malta, their effectiveness and adequacy to-date, and to propose possible improvements. Method: A study on 18 interviewees associated with pharmaceutical and economical pricing policies was performed. A literature review analysis of the local published media regarding the subject was also undertaken to confirm personal interpretations given and to bridge information gaps. Key Findings: There are two separate reference pricing systems in place; one for the private and another for the public health sector, operating via different economic mechanisms. Reasons for resorting to such systems centred around the lack of access and affordability of medicines. This situation had emanated from an inefficient business environment, lack of proper government regulation and management and an imbalance of power between medicines' suppliers, consumers and patients. A total of 18 respondents participated in the study. Two out of the 18 respondents considered the system successful, 6 deemed it unsuccessful and 7 thought the system had limited success. Results show that reference pricing may be regarded as a fair and simple means of monitoring and comparing local medicine prices with those of other countries. Reference pricing systems do not cater for many of the problems associated with such pricing. Conclusions: Reference pricing cannot be taken out of context in an integrated pharmaceutical system. The situation must be tackled holistically to address the real issues hindering the establishment of fair prices of medicines for Maltese consumers. Policy systems should be constructed in accordance with Malta's particular political, economic and cultural requirements in line with local and European Union (EU) legislation. ; peer-reviewed

Objective: To determine the age distribution of patients and the total drug cost. To establish the average cost per age group and identify factors that may influence cost. Method: A pilot study was conducted by selecting by convenience sampling a number of patients over 18 years who were registered in the Pharmacy of Your Choice scheme with a community pharmacy where the study was carried out. For each patient, type, frequency and cost of medication supplied were identified from treatment cards and from Government Health Procurement Services (GHPS). Key findings: Data was collected for 491 patients (aged between18-98 years) were 272 (55%) were females and 10% (n = 47) were institutionalised. Eight percent (n=395) were prescribed drugs for cardiovascular diseases which constituted 50% of the total drug expenditure. Daily cost per patient was one euro. Pearson correlation value (p0.05). Conclusions: Cost of drug treatment is vital information that financing providers and policy makers require for the allocation of budgets. Findings suggest that populations are ageing, cost increases with age and that gender and setting influence the treatment being provided. ; peer-reviewed

Objectives: To assess the knowledge of pharmacoeconomic (PE) information in patient groups, healthcare professionals, Government Formulary List Advisory Committee (GFLAC) and Pharmaceutical Research Based Industry Malta Association (PRIMA) members, to determine the extent to which PE information is used in formulary decision making and to define the specific challenges to adapt and establish the PE concept locally. Method: A cross sectional study was conducted to investigate local PE knowledge and trend of use. A structured questionnaire was drafted. The questionnaire was distributed electronically to GFLAC members, health care professionals, patient groups and PRIMA members. A review of international PE guidelines was carried out followed by development of another questionnaire to obtain feedback from experienced Health Technology Assessment (HTA) and PE units in European countries. This questionnaire was disseminated to European organisations after obtaining permission to use 33 European countries listed on the International Society for Pharmacoeconomics Organisation (ISPOR) and the European Network for Health Technology Assessment (EUnetHTA) mail lists. Key Findings: Fourty out of a total of 74 electronically distributed questionnaires (response rate 54%) were returned. With regards to formulary decision making, the most influential profession was that of physicians whilst the most influential factors were drug efficacy and drug safety. The majority of participants are in favour of PE being required in formulary decision making. A total of 15 replies from 13 different European agencies were obtained. The majority of respondents agreed that Malta should adopt its own system of PE assessment. A further suggestion addressed the adaptation and tailoring of an existing national system and application of pharmacoeconomics in special cases. Conclusion: Results obtained in this study indicate that the concept of pharmacoeconomics should be required in formulary decision making and that Malta would benefit from adopting its own system of PE assessment. ; peer-reviewed

A poster presentation regarding the analysis of corrections following regulatory inspections. Introduction: A good quality system ensures that the medicinal product's quality is maintained throughout the whole lifecycle, safeguarding patient's well-being. The European Union (EU) lays down directives for Member States to ensure that quality levels are achieved. GMP and GDP inspections are undertaken by regulatory agencies to ensure compliance with the EU Directives. Aims: To analyse the corrections resulting from GMP/GDP regulatory inspections carried out by the regulatory authority on manufacturers and wholesalers. ; N/A