Importance Of Tendering After Patent Expiry In Germany

VA L U E I N H E A LT H

including connections drawn as circles, shows that European countries are at the center of global HTA networking. Additionally, membership in only one international HTA society is high for European (n= 141, %= 43.1) and North American (n= 98, %= 30) organizations, and the number of memberships in five international HTA societies is high for Asian (n= 1, %= 50) and North American (n= 1, %= 50) organizations.  Conclusions: Strengthening international collaboration should remain a high priority for global HTA decision makers for many years to come. However, international HTA society memberships remain driven by geographic region. Improving international HTA organizations’ roles in translating and disseminating knowledge throughout different parts of the world, building platforms for achievement discussions, and creating common data-sharing strategies are advisable goals to improve the quality of HTA activities and to make health technologies and evidence-based medicine available for everyone. PHP121 Pharmaceutical Care Workload And Workforce Requirement At Ministry Of Health Primary Care Centers During Ten Years Mass Gathering Hajj (2006-2015) In Makah Regions, Saudi Arabia Alomi YA1, Khayat NA2, Al-Hennawi KI1 of Health, RIYADH, Saudi Arabia, 2Makkah Medical Affairs, RIYADH, Saudi Arabia

20 (2017) A399–A811

A673

city. The workforce requirements calculated based on MOH workforce standards per bed and the workload drives as central pharmacy services, patient specific pharmacy activities, and general administration specific pharmacy activities. The pharmacy technician workforce excluded in the calculations  Results: The total number of prescriptions (99,886-257,545) with average (180,120), it represented (5.1112.07%) with average (7.86%) of all pilgrims. The average number Ambulatory care prescription were (69,517) while (22,959) was an emergency prescription, and (2,935) inpatient prescriptions. The average number of pharmacist needed (9.49 FTE) for inpatient services per hospital, (48.85 FTE) for Emergency services per hospital, and (21.85 FTE) for Ambulatory care services per hospital. The average number of pharmacist calculated per hospital was (37.1 FTE), while the mean number pharmacist needed to base on workload for all services was (80.19 FTE) per hospital. It is (2.16 fold) more incremental than MOH pharmacist workforce standards per bed. There were not any central pharmacy activities, and clinical pharmacy services or administrative pharmacy activities.  Conclusions: The Workload analysis of pharmaceutical care services as a part of total quality management indicators during mass gathering Hajj. Clinical pharmacy activities missed with emphasis on patientspecific clinical pharmacy. There is a highly demand of pharmacists workforce during mass gathering Hajj period in Makah Region, Saudi Arabia.

1Ministry

Objectives: To explore the pharmaceutical care services workload and workforce requirements at Ministry of Health primary health care centers during mass gathering Hajj ten years (2006-2016), Saudi Arabia  Methods: It is a retrospective analysis of ten years (2006-2015) of primary healthcare center (PCC) pharmacies workload during mass gathering Hajj period. The duration of workload collection was 15 days. The pharmacist and pharmacy technicians provide pharmaceutical to all patients either Pilgrim or not Pilgrim at Makah region. The workforce requirements calculated based on MOH workforce standards of primary health care center and the workload drives as central pharmacy services, patient specific pharmacy activities, and general administration specific pharmacy activities  Results: The total number of prescriptions (226,824-505,753) with average (411,317), it represented (7.12-20.25%) with average (16.77%) of all pilgrims. The average number PCC prescription at holy places were (274,316) and (137,001) from Makah city. The average number of PCC order at sacred sites was (9,133) per day and contained (27,399) medications, while at PCC in Makah city was (18,288) prescriptions per day and contained (54,864) drugs. The average time of dispensing PCC prescription was 4 minutes. The average number of pharmacist needed (24.81 FTE) per each PCC at holy places, and (27.72 FTE) per each PCC at Makah city. The average number of pharmacist based on MOH standards per each PCC was (4 FTE) while the mean number pharmacist needed based on workload was (52.53 FTE) per each PCC. It is (13.13 fold) more incremental than MOH pharmacist workforce standards per PCC.  Conclusions: The pharmacy workload analysis at primary health care center reflected the real demand for pharmacists. Clinical pharmacy activities at PCC missed with emphasis on patient-specific clinical pharmacy. There is a high shortage of pharmacists at PCC during mass gathering Hajj period in Makah Region, Saudi Arabia. PHP122 Landscape Of Reported Drug Shortages In European Countries De Weerdt E, Schaerlaeken S, Simoens S, Casteels M, Huys I KU Leuven, Leuven, Belgium

Objectives: Drug shortages are a known problem in Europe. However, detailed information about the affected drugs remains missing. The aim of this study is to estimate the scope of the reported drug shortages in European countries.  Methods: Fifty national medicine authorities in Europe were asked to share their database of reported drug shortages between January 2011 and December 2016. If a database was obtained, additional information was requested about the reporting conditions. Descriptive statistics were used to analyze the database.  Results: Twentyfive European medicine authorities answered, but only 13 of those kept records of the reported drug shortages. Differences are observed in who is allowed to report drug shortages and in the drugs included in the databases, which complicates comparing national databases. Information of 18993 drug shortages between 2011 and 2016 is collected from 13 countries (Austria, Bosnia and Herzegovina, Croatia, Czech Republic, Estonia, Germany, Latvia, Lithuania, Norway, Poland, Slovakia, Spain and Switzerland). Czech Republic is responsible for almost half of these reported drug shortages. One fifth of the reported drug shortages are drugs used in the therapeutic area of the nervous system. Drugs of the cardiovascular system are responsible for 17% of the reported shortages. The classes of anti-infectives for systematic use and antineoplastic and immunomodulating agents each account for about one tenth of the reported drug shortages. Considering the form of the reported drug shortages, half of them are tablets and one fifth are solutions. Oral is the most common route of administration and accounts for 61%, while injection (27%) is the second most common route of administration which is affected by the reported drug shortages.  Conclusions: Although no specific ATC-class is preferably affected by drug shortages, a certain type of formulation (tablets) and route of administration (oral) are dominant in the reported drug shortages in Europe. PHP123 Pharmacy Workload And Workforce Requirement At Ministry Of Health Hospitals During Ten Years Mass Gathering Hajj (2006-2015) In Makah Region, Saudi Arabia Alomi YA1, Khayat NA2, Alhannawi K1 of Health, RIYADH, Saudi Arabia, 2Makkah Medical Affairs, RIYADH, Saudi Arabia

1Ministry

Objectives: To explore the pharmaceutical care services workload and human resources requirements at Ministry of Health (MOH) Hospitals during mass gathering Hajj ten years (2006-2015) in Saudi Arabia  Methods: It is a retrospective of ten years (2006-2015) of hospital pharmacies workload during mass gathering Hajj period. The duration of workload collection was 15 days. The pharmacists provide pharmaceutical to all patients either Pilgrim or not Pilgrim at Makah region. It included Mona holy places hospitals; Arafa holy places hospitals, and Makah

PHP124 Health Technology Assessment To Improve Patient Care Through Pharmaceutical Care: Clinical Pharmacist’s Perspective Kanneganti S Aster Ramesh Hospital, Guntur, India

Drug Related Problems could result in the medication errors, adverse events, drug interactions and harm to patients. AIM: The main aim of the study was to assess and evaluate the Clinical Pharmacist’s interventions in health care i.e., HTA and its application to improve and optimize patient care through pharmaceutical care and to achieve accuracy in patient treatment.Methods: A prospective, observational and interventional study. Ethical approval was obtained before starting the present study. The inpatient medication charts and orders drug related problems were identified, analysed and rectified by ward and practicing clinical pharmacists within the inpatient pharmacy services, using the parameters: dose, rate of administration, presentation and/or dosage form, presence of inappropriate/unnecessary drugs, necessity of additional medication, more proper alternative therapies, presence of relevant drug interactions, inconsistencies in prescription orders, physical-chemical incompatibilities/solution stability. From this evaluation, the drug therapy problems were classified, resulting clinical interventions made.  Results: out of 360 clinical pharmacist interventions followed, male (71.66%) predominance was noted over females (28.33%). Most of the DRP observed were dispensing errors(26.11%),improper drug selection (17.22%),followed by untreated indications (14.4%) Majority of the clinical pharmacist recommendations were on need for proper dispensing(26.11%), and drug change (18.05%). The acceptance rate of intervening clinical pharmacist recommendation and change in drug therapy was found to be high (86.66%). Clinical pharmacists have greater potential in preventing and/or minimizing the DRPs. CONCLUSION: Technology assessment in health care is a multidisciplinary field of policy analysis which studies ethical, social, medical and economic implications of development, diffusion and use of health technology. From the multidisciplinary health technology assessment the methods followed for this study were found to be useful for not only enhancing the appropriate use of drugs in a clinical setting but also sow a seed for the evolvement of HTA in India with clinical pharmacist as its pathfinder. PHP125 Importance Of Tendering After Patent Expiry In Germany Fink C, Ecker C Ecker + Ecker GmbH, Hamburg, Germany

Objectives: The loss of market exclusivity is a natural milestone in the lifecycle of a patent-protected pharmaceutical. Once the patent protection for a substance expires, generic equivalents can enter the market and compete with the original brand-name product. As generics typically are sold at substantially lower prices, the companies are challenged to keep their share of the market. A key to managing patent expiry and the impending decline in sales volume and revenue could be entering into rebate contracts with German statutory health insurance companies. Those contracts oblige the pharmaceutical companies to grant a discount on the list price. In turn, the health insurers restrict supply to the product to which the contract applies.  Methods: The analysis is based on substances that lost patent protection in Germany during the period from 2013 to 2016. Selected substance markets were analyzed by comparing the tender announcement by health insurers, the tender strategy of manufacturers, and price and volume trends. Key issues are the time of tender announcement and the preferred tender models by health insurers as well as the identified strategies of originators.  Results: 40 relevant substance markets were identified. Health insurers frequently announce tenders prior to patent expiry with “open-house-models”. The large majority of pharmaceutical companies use rebate contracts as a defense strategy. Especially shortly after patent expiry rebate contracts have proven a practicable strategy for protecting market shares.  Conclusions: Rebate contracts could be an instrument for originators to prevent substitution at the pharmacy and to delay erosion of market share. In this context, the importance of so called “open-house-models” is increasing. In those models, the health insurers offer eligible requirements to all interested pharmaceutical manufacturers/ importers. The implementation of an effective tender strategy requires early preparation and changes in the business models for concerned pharmaceutical companies. PHP126 The Development Of Acute And Chronic Inpatient Bed Capacities In Neurological, Neurosurgical And Psychiatric Professions Between 2002 And 2016 In Hungary Ágoston I, Endrei D, Molics B, Szarka E, Elmer D, Gyuró M, Sebestyén A, Boncz I University of Pécs, Pécs, Hungary