Developments in Anticancer Drugs Preparation Activity in Hospitals Pharmacies Units (HPU) and Their Impact on the Activity of Paris University Hospitals (AP-HP)

Speaker(s)

Moracchini M1, Tano M2, Siorat V3, Parent de Curzon O3, Paubel P4, Madelaine I5, Degrassat Theas A2
1General Agency of Equipment and Health Products (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP), Courbevoie, 92, France, 2General Agency of Equipment and Health Products (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP) ; Law and Health Economics Department, Faculty of Pharmacy & Health Law Institute (INSERM UMR S1145) University of Paris Cité, Paris, France, 3General Agency of Equipment and Health Products (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France, 4General Agency of Equipment and Health Products (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP) ; Law and Health Economics Department, Faculty of Pharmacy & Health Law Institute (INSERM UMR S1145) University of Paris Cité, Paris, Paris, France, 5Saint-Louis Hospital, Paris, Ile de France, France

Presentation Documents

OBJECTIVES: Paris University Hospitals’ (AP-HP) pharmacies units (HPU) are responsible for preparing antineoplastic agents. They include cytotoxics and monoclonal antibodies (mAbs). The overall number of sessions is increasing since 2017. In the same time, AP-HP’s spending for injectable anticancer drugs administered during sessions has nearly doubled in six years, reaching nearly €400M in 2022. Little is known about HPU’s activity trends despite the staff shortages.

The study aims to take stock of HPU activity in relation to medical staff ratios for 5,000 preparations. The threshold of 5,000 preparations was chosen because, below this level, the French Society of Oncology Pharmacy recommends pooling production with another hospital.

METHODS: Using annual summary tables provided by the fourteen HPU and internal order management software, we compared the evolution of anticancer drug consumption and chemotherapy preparation activity in relation to the ratio of medical staff for 5,000 preparations at AP-HP from January 2017 to December 2022.

RESULTS: The number of preparations realized by HPU has decreased slightly from 375k in 2017 to 356k in 2020, but has increased over the last two years (364k in 2022). It has been driven by an increase in mAbs production since 2017 (70k in 2017 versus 100k in 2022), as opposed to cytotoxics which has decreased (299k in 2017 versus 264k in 2022).

However, the full-time equivalent (FTE) ratio of pharmacists and pharmacy technicians for 5,000 preparations fell from 0,54 and 1,28 to 0,42 and 1,19 respectively. Due to a staff shortage, part of the mAbs production is done directly in the unit care by nurses.

CONCLUSIONS: The FTE ratio for medical staff reduced between 2017 and 2022. This trend does not reflect the increasing number of temporary workers, and the training time they need/receive. The valution of this activity would require more detailed medico-economic studies.

Code

OP25

Disease

Biologics & Biosimilars, Oncology