HPE What price can you put on safety? - Page 3

Sun Pharmaceuticals has developed a range of ready-to-administer (RTA) products, including intravenous (IV) gemcitabine bags and 50ml midazolam syringes for use in intensive care units (ICU). Eight Directors of Pharmacy from six European countries met in Amsterdam to share their experience of RTA products and to consider what the future might hold. If licensed RTA products were freely available, most hospital pharmacies across Europe would be using them, on the grounds that they guarantee quality and stability, enhance patient safety by minimising the possibility of compounding and administration errors and increasing aseptic unit capacity. But, of course, they cannot be free, and so their procurement becomes a trade-off between their direct cost and their direct and indirect benefits. Where and how that line is drawn, and the role of international, European and local guidance in the decision-making process were the focus of discussion of this gathering of European Directors of Pharmacy. They began with a critical appraisal of RTA 50ml midazolam syringes. RTA 50ml midazolam ICU syringes Who are the stakeholders and what is the procurement process? Across the EU, procurement is discussed/decided between ICU pharmacists and intensive care departmental medical chiefs (cost), with nurses playing a crucial advisory role. In Spain, there is a regional tender for syringes, with a centralised expert and technical committee establishing requirements and offering the final decision, ratified by the regional healthcare government. A hospital committee proposes, analyses and decides for devices not included in the tender. In the UK, ICU pharmacists and clinicians (anaesthetists and intensivists) are the major stakeholders, with pharmacy procurement designing any framework/contract. Costs/Benefits • The benefit is not to minimise the cost, or to save nurses’ time, but to minimise the risk to the patient by preventing administration errors; there is unfortunately no price tag on that, but there was consensus that this is the only way forward. • If a company has a licensed RTA product with a long shelf life that is terminally sterilised, that would be a winner. As phrased by one delegate: if we can buy it, then we buy it. • In the interest of patient safety, it is not possible to overstate the importance and benefit of proper labelling and barcoding on syringes and primary packaging. This is an area in which the benefit of industry-prepared RTA syringes can easily be sold. As regards colour coding, this is perceived to be fraught with danger, unless one can be assured of EU-wide uniformity. • Calculations can be deceiving. One of the delegates from Germany cited the example of 50ml KCl syringes: his hospital’s ICUs prepare 700 KCl syringes every day, which, at one minute per When we are so pushed for capacity, why would you make something when there is a suitable licenced alternative at a reasonable cost? Alison Beaney, UK DELEGATES Alain Astier Formerly Head of Department of Pharmacy and currently Emeritus Professor of Clinical Pharmacy and Biotechnology, Henri Mondor University Hospital, Paris, France Alison Beaney Quality Assurance Specialist Pharmacist and Visiting Professor, University of Sunderland, UK Robert ten Broeke Head of Pharmacy, Catharina Hospital, Eindhoven, Netherlands Martin Hug Chief Pharmacist, University Medical Centre Freiburg, Germany Antonio Lalli Director of Pharmacy, Hospital San Giovanni di Dio, Naples, Italy David Lopez Vall d’Hebron University Hospital, Barcelona, Spain Andrea Machiavelli Director of Pharmacy, ASST Cremona, Italy Theresa Saklatvala Chair, Content Director, Cogora Irene Krämer Director, Pharmacy Department at the University Medical Center, Johannes Gutenberg- University, Mainz, Germany hospitalpharmacyeurope.com | 2020 | 3