COVID-19 and Containment: Economic IMPACT on Outpatient Drug Dispensation in Hospital Pharmacies of Paris

Author(s)

Hicham H1, Degrassat Theas A2, Paubel P3, Siorat V4, Parent de Curzon O5
1General Agency of Equipment and Health Products (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, 75, France, 2General Agency of Equipment and Health Products (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP), PARIS, France, 3General Agency of Equipment and Health Products (AGEPS), Assistance Publique-Hôpitaux de Paris (AP-HP); Health Law Institute, INSERM UMR S 1145, Paris University ; Faculté of pharmacy, Paris University, Paris, France, 4General Agency of Equipment and Health Products (AGEPS), Public hospitals of Paris (AP-HP), Paris, France, Paris, France, 5General Agency of Equipments and Health Products (AGEPS), Paris, France

The emerging infectious disease COVID-19 became a pandemic in early 2020. In France, containment was set up on March 16 for 8 weeks to prevent massive contamination. Ambulatory medicines are mostly dispensed by community pharmacies (CP), while some specific drugs can only be provided by hospital pharmacies (HP), medications used for HIV or hepatitis follow a dual dispensing path.

OBJECTIVES

: The objective is to assess the containment’s economic impact (week 12-20) on outpatient drug dispensation (ODD) at Public Assistance Hospitals of Paris (APHP).

METHODS

: ODD expenditures at APHP were analyzed over the five first months of 2020 and compared with 2019 and 2018, with a focus on main therapeutic classes contributing to amount variations.

RESULTS

: From January to May, ODD expenditures decline in 2020 (-15% versus 2019). This decrease is mainly due to negative quantity effect (index at -9.0 % between 2019 and 2020) and price effect (-6.1%). Antiviral drugs, mostly treatment against hepatitis C and HIV, strongly drive down expenditures (-51% versus 2019) with a quantity index of -44.6%. The largest monthly drop is observed in April 2020: -21% versus March (from €25.6M to €20.1M). Regarding global weekly variation, ODD reached €6.7M (+15%) week 13 (March 23-29) then collapsed to €3.5M (-47%) week 14. The main therapeutic classes underlying this peak/collapse (Week 13/14) are antivirals (+128%/-69%), antihemorrhagic drugs (+45%/-27%) and immunosuppressive drugs (+31%/-57%).

CONCLUSIONS

: Hepatitis medication dispensing path change in 2018 (From HP only to both pharmacies), new HIV generic medicines and price reduction, lead to an ODD steady decline since 2018. COVID-19 has emphasized this trend in 2020: the massive drop of ODD week 14 could be explained by early treatment storage by patients. Our results match with those of the French National Agency for Medicines latest report[1], which notes a stock phenomenon (peak/collapse) for ambulatory medication use during COVID-19 period.

[1]https://www.ansm.sante.fr/S-informer/Points-d-information-Points-d-information/Usage-des-medicaments-de-ville-en-France-durant-l-epidemie-de-Covid-19-point-de-situation-a-la-fin-du-confinement-Point-d-Information

Conference/Value in Health Info

2020-11, ISPOR Europe 2020, Milan, Italy

Value in Health, Volume 23, Issue S2 (December 2020)

Code

PMU12

Topic

Economic Evaluation, Epidemiology & Public Health, Health Policy & Regulatory

Topic Subcategory

Budget Impact Analysis, Novel & Social Elements of Value, Public Health, Public Spending & National Health Expenditures

Disease

Infectious Disease (non-vaccine), Oncology, Reproductive and Sexual Health

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