[Drug dispensation at both community and hospital pharmacy, the highly active antiretrovirals example].

Objectives: Highly active antiretroviral therapies against the human immunodeficiency virus are available for patients in France in community pharmacy or in hospital pharmacy. More than 20 years after the implementation of the dual delivery system, it seems necessary to question the relevance of the dual dispensing circuit both in terms of service provided to patients and expenditure for health insurance.

Methods: The health insurance files were used to quantify the delivery of antiretrovirals therapies in the community pharmacy and in the hospital pharmacy.

Healthcare Costs Associated with Potentially Inappropriate Medication Prescribing Detected by Computer Algorithm Among Older Patients.

Introduction: Potentially inappropriate medication prescribing (PIP) among older patients is associated with an increased risk of adverse events and hospitalization, and sometimes increased healthcare costs.

Objective: The aim of this study was to explore the association between healthcare costs and PIP exposure among older patients.

Methods: Analyses were conducted using data from the Multidomain Alzheimer Preventive Trial (MAPT).

Screening for deficits on intrinsic capacity domains and associated healthcare costs.

Background/objective: Intrinsic capacity (IC) defined by the World Health Organization is divided into six domains (locomotion, psychological, vitality/nutrition, cognition, vision and hearing). The main objective of this study therefore is to explore the association between healthcare costs and IC domains deficits among older patients.

Participants And Setting: This longitudinal secondary analysis was performed on data from the Multidomain Alzheimer Preventive Trial (MAPT), a 3-year randomized controlled trial with non-demented community-dwelling participants aged 70 years or over.

Potentially Inappropriate Medication Prescribing Detected by Computer Algorithm among Older Patients: Results from the MAPT Study.

(1) Background: Some medications may be dangerous for older patients. Potentially inappropriate medication prescribing (PIP) among older patients represents a significant cause of morbidity. The aim of this study was to create an algorithm to detect PIP in a geriatric database (Multidomain Alzheimer Preventive Trial (MAPT) study), and then to assess the algorithm construct validity by comparing the prevalence of PIP and associated factors with literature data.

Impact of a Pharmacist-included Mobile Geriatrics team intervention on potentially inappropriate drug prescribing: protocol for a prospective feasibility study (PharMoG study).

Introduction: Research has shown that potentially inappropriate drug prescription (PIDP) is highly prevalent in older people. The presence of PIDPs is associated with adverse health outcomes. This study aims to evaluate the impact of a PHARmacist-included MObile Geriatrics (PharMoG) team intervention on PIDPs in older patients hospitalised in the medical, surgical and emergency departments of a university hospital.

[Analysis of regulatory status changes of drugs in France: 2010-2019].

Objectives: The existence of borderline products between the status of a medicinal product and other less regulated products allows some products to have different statuses or even to change from one status to another. In order to quantify these changes, a review of medicines that have changed from drug status to other statuses (medical device, cosmetic product or food supplement) in France between 2010 and 2019 was performed.

Method: The lists of medicinal products with archived or revoked marketing authorization (MA) from the French National Authority's Register of Medicinal Products were analyzed in order to identify the medicinal products withdrawn from the market between January 1, 2010 and September 30, 2019 that could be considered as products with a "potential for status change".

Cost analysis of potentially inappropriate medication in older hospitalized patients.

: Pubmed literature search show that the prescription of potentially inappropriate medications is a major concern in older hospitalized patients, both from a clinical and financial perspective. This study aims to identify factors associated with exposure and potentially inappropriate medication costs in older hospitalized patients and to assess the financial impact of substituting these medications with safer alternatives. : We performed an observational cross-sectional study of all patients aged 75 years or older hospitalized in a university hospital (except geriatric wards) on a given day.

Cost-minimization analysis between intravenous iron sucrose and iron sucrose similar in hemodialysis patients.

Objectives: Intravenous iron and erythropoiesis-stimulating agents are used to manage anemia in chronic hemodialysis patients. The interchangeability between intravenous iron sucrose preparations is still debated. We evaluated how cost and effectiveness were impacted when chronic hemodialysis patients were switched from an original iron sucrose product to an iron sucrose similar preparation.

Patient access to orphan drugs in France.

Background: Since incentives were introduced to promote orphan drugs in Europe, several dozens of drugs have been registered at the European level. However, patient access on a national level remains very heterogeneous across Europe. This can be explained by healthcare organization and drug reimbursement, which are within the purview of each Member State.

[Chapter 5. Biosimilars: a regulatory framework at the crossroads of health security and health economics].

Expiration of patents for biologic drugs allows marketing of biosimilars as copies of reference biologic drugs. The major benefit of biosimilars for health systems relies on the fact that they are likely to bring progress in terms of efficiency and accessibility. Their legal framework is mixed: European for quality, efficiency and safety; national for socio-economic characteristics.

Cost Effectiveness of Candida Polymerase Chain Reaction Detection and Empirical Antifungal Treatment among Patients with Suspected Fungal Peritonitis in the Intensive Care Unit.

Background: Mortality from intra-abdominal candidiasis in intensive care units (ICUs) is high. It takes many days for peritoneal-fluid fungal culture to become positive, and the recommended empirical antifungal therapy involves excessive costs. Polymerase chain reaction (PCR) should produce results more rapidly than fungal culture.

Drug selection in French university hospitals: analysis of formularies for nine competitive pharmacological classes.

Aim: To give a panorama of the selectivity and agreement of French university hospitals' drug formularies (HDF) for nine competitive classes.

Methods: All university hospitals were asked to send their HDF and selection criteria as of January 2009 for nine competitive pharmacological classes (proton pump inhibitors, serotonin antagonists, low molecular weight heparins, erythropoietins, angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists, statins, α-adrenoreceptor antagonists and selective serotonin re-uptake inhibitors). Selectivity of HDF was estimated by the percentage of drug entities selected by the hospital within the pharmacological class.

Impact of etanercept on the costs of rheumatoid arthritis (RA): results from a French observational study.

Introduction: Economical impact of rheumatoid arthritis (RA) has been widely modified thanks to TNF inhibitors. Our study aims to estimate the impact etanercept prescription, in term of health resources consumption, within a regional cohort of French RA patients.

Methods: The study included 148 RA patients, with a mean follow-up duration of 343 days before and after etanercept initiation.

[Cost of rheumatoid arthritis in france: comparison leflunomide/etanercept].

Treatment of rheumatoid arthritis was deeply modified with the availability since 1999 of anti-TNFalpha. The clinical superiority of these drugs compared to traditional treatments is proven, but can one make the assumption that the cost of these innovative treatments is partially compensated by a reduction of consumption of other health resources? A retrospective observational study was carried out in the Midi-Pyrenees area, from the point of view of health insurance, to compare the consumed health resources between two cohorts of patients, one treated by etanercept (Enbrel) and the other by leflunomide (Arava). Two hundred and fifty three patients were included in the etanercept cohort and 539 in the leflunomide cohort.

[Methods for the measurement of drug consumption: application to antibiotics].

Objective: The aim of this article is to present and compare the different methods used to study drug consumption.

Methods: Particular attention is given to one method, the defined daily dose (DDD), for antibiotic dispensation data in Toulouse University Hospital Centre between 2001 and 2003.

Results: Data, expressed in units of packaging, were converted into grams of active substance and then to number of DDD.