The EAHP
Thursday 28 March 2019
Daily dose
Information that makes you feel good! CHECK THE ELECTRONIC VERSION AZ_EAHP_PRINT.pdf
CONGRESS AGENDA
KEYNOTE 1 PREVIEW
Full programme of activities
The OMICS approach - the buzz that makes the world go round !
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POLICY ARTICLE The Falsified Medicines Directive (FMD) – EAHP’s members take stock
Mariona Ribó
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Kees Neef, 20 years of dedication to EAHP When and why did you join the EAHP? My first contact with EAHP was as a speaker in a satellite symposium on Automation in drug distribution. I reported our experience with a distribution robot called Homerus and the Pixus cabinets. That was in the year 2000. In 2006, I joined the Scientific Committee as country representative for The Netherlands. The structure of the committee back then was to add two hospital pharmacists to the SC from the country where the congress took place in order to add some “couleur local” to the committee. This ended when EAHP grew and had to move to bigger congress centres. Now, we automatically go back to the same centres in the same countries as very few congress centres can accommodate EAHP’s scientific programme. That is also the reason that the previous congress in Barcelona was only 5 years ago. After the congress in Maastricht in 2008 I was asked to remain a member of the committee. After 4 years, I succeeded Vagn Handlos as the SC Chairman and became a Board member with the title Director of Education, Science and Research. When comparing your first Congress (Maastricht 2008) with your last (Barcelona 2019), how much has changed? The change between those years is enormous. Looking at the attendance figures – from 1800 participants in Maastricht to around 3400 last year, this indicates that the congress is appreciated more and more. The structure of the programme has evolved from incidental lectures or presentations to a programme with a theme and presentations linked to our professional activities and the
European Statements of Hospital Pharmacy. This gives a strong backbone to a substantial educational programme. People come to our congress (the second largest congress of hospital pharmacy in the world after the ASHP Mid-year congress) mainly due to the high educational content. Our congress is internationally recognised looking at the number of participants attending from outside of Europe. In which direction did the Scientific Committee evolve under your chairmanship? I think that I have given more structure in the discussions on the content of the seminars. The most important meeting of the year became the May meeting. In this meeting the theme and global content of the next congress is set. Thanks to the computer program X-mind and the structure of the statements, this discussion can take place and lead to a very fruitful result. Also, the abstract and poster judgement procedure has been simplified. Several years ago, we were busy making a selection of submitted poster abstracts on a weekend in November. We all (21 committee members) were busy on Saturday until midnight to review and discuss the poster abstracts. We changed this timeconsuming activity to a process where pairs of two SC members judge a fixed number of abstracts (100120). This simplified the process as the abstracts are only brought into the full SC meeting if both review members don’t agree. I can say with certainty, that the SC has become more professional in their work. Looking back at the countless Scientific Committee meetings, what is your favourite memory?
I have two favourite events that often come back in my memory. First were the exhausting November meetings of the poster abstract reviews where we worked until midnight to get everything ready in time. The second one was the snow in Paris during our congress which was my first independently organised congress after succeeding Vagn Handlos as the SC Chairman. We launched the first Synergy satellite. The key speaker of that seminar sent an email that he was unable to come to Paris due to agenda problems. What to do: Cancel the first Synergy? Find another speaker? We finally found another speaker but that was not the only problem. The night preceding the start of the congress there was an exceptional snowfall in the northern part of France, including Paris. 10 cm of snow made train, plane and car travel virtually impossible. Some people shared a taxi from Brussels to Paris, some people arrived by train with a delay of 12 – 24 hours and some people returned home. What piece of advice would you provide to me as your successor? Take care of your Scientific Committee members. They voluntarily spend a lot of time working in the committee: 6 long weekends annually, 3 keynotes, 18 – 20 seminars and some workshops, the Synergy satellites and an increasing number of Synergy Masterclasses. Keep the scientific character of the presentations at high a level as this why people attend EAHP’s educational events. Thomas De Rijdt, EAHP Scientifi c Committee Member
Tevadaptor® continues to demonstrate safety with 2 new peer-reviewed articles TDPT-IL-00129
www.tevadaptor.com
Visit us at booth
#25 Also visit our new website!
24th Congress of the EAHP
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THURSDAY, 28 MARCH DATE/TIME MEETINGS/EVENTS
ROOM
06.30 -17.00
Entrance Hall
Registration opens (individuals, groups and exhibitors)
Synergy Satellite Event - Facing Brexit and FMD - Is Europe ready for the double “storm”? S. Kohl; A. Mathieu-Mendes; M. Dias
07.00 – 08.30 08.30
Exhibitions opens
Seminars Seminar IG1 - Implementation science - the inside story M. Teichert*, L. Poulsen
113
Seminar PC2 - Preparation for neonates - a sensitive population M. Paulsson*; I. Sviestina
114
Seminar CPS3 - Optimising medication adherence M. Airaksinen; U. Hedegaard
08.45 – 10.315
Area 1+2+3
Anticoagulation – improving efficacy and preventing side effects (sponsored by an educational 116 grant from Bayer) L. Van der Linden*; C. Quintens.
08.45 -10.15
08.45 -10.15
211
115
Seminar SPD1 - Health technology assessment - one step further! J. Perelman; M. J. Alcaraz
117
Seminar ER1 - When numbers are small - clinical trials in rare diseases A. Addis; F. Houÿez
211
Workshop 4 - Pharmacist-patient relationship in clinical trials B. Brignolo Ottolini ; S. V. Rossi
124
Interactive Session 1 - The role of pharmacogenomics in medication optimisation R. Turner; B. Sproule
125
Industry sponsored satellites ICU MEDICAL “Hazardous Drug Safety - An Update on Guidelines, CSTD Compliance Test and What to Consider with 111 a CSTD” FRESENIUS KABI “The pharmacist’s role in meeting the needs of every parenteral nutrition patient”
112
10.15 - 11.15
Coffee break and attended posters
Area 1+2+3
11.00 – 12.00
Keynote 2 - Clinical human factors - delivering healthcare under pressure J. Carthey
Forum Auditorium
12.15 - 13.30
Lunch
Forum Auditorium
Bayer – Meet the Expert
Bayer #19 Exhibition area
Bayer – Meet the Expert
Bayer #19 Exhibition area
12.20-12.50 12.50-13.20
Synergy Satellite Event - Biosimilars - challenging misconceptions, optimising uptake, maximising value (financial support was provided by Pfizer Limited as a Medical and Educational Goods and Service) M. Flume*; A. McWhirter
13.30-15.00
13.30-15.00
116
Seminar Seminar CPS1 - Responding to individual metabolism by genomics and metabolomics C. Nievergelt; S. J. Krähenbühl
113
Seminar PQ3 - Social media and pharmacovigilance 2.0 A-M. de Ferran; U. Moretti
114
Seminar PC3 - From gene therapy to cell therapy - what about hospital pharmacy? T. Hoppe-Tichy*; N. A. A. de Miranda
115
Seminar PQ2 - High-alert medicines and risk minimisation of medication errors (this session will run once) O. Lapatto-Reiniluoto; Y. Jani
117
Seminar PC4 - Radiopharmacy - does it glow in the dark? E-M. Klebermass; G. Bormans
125
24th Congress of the EAHP
13.30 – 15.00
15.00 - 15.45
Seminar PC1 - Individual preparations - time to change the law? H. Scheepers; P. Le Brun
211
Workshop 2 - To make or to buy? D. Devolder; T. Storme*
127
Industry sponsored satellites AMGEN “Upholding quality patient care with biosimilars”
111
Coffee break
Area 1+2+3 Synergy Satellite Event - Biosimilars in haemato-oncology - new blood, old questions (sponsored by an educational grant from SANDOZ) B. Klindt Poulsen; N. A. A. de Miranda; A. Gouveia
13.30 – 15.00 15.45-17.15
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Seminars Seminar CPS2 - Medicines optimisation in paediatric patients B. Deleenheer; K. Hämeen-Anttila Seminar SPD3 - Inaccessibility of the right drugs A. Sieg; S. Luterbacher
15.45-17-15
116
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Seminar SPD2 - Managed entry agreements - risk sharing and beyond S. Brown; C. Ferri
115
Seminar IG2 - May I please speak with my hospital pharmacist? (this session will run once) K. Ocko; C. Fonzo-Christe; C. Hynes
117
Seminar PQ1 - Drug-related hospital admissions - detection and prevention O. Dalleur; S. Thevelin; E. Uitvlugt
211
Workshop 3 - Learning from medication errors Y. Jani; C. Linden-Lahti Workshop 1 - Human factors in practice J. Carthey
124
Industry sponsored satellites
J2
B. BRAUN Melsungen AG “IV Ibuprofen – A new option in multimodal analgesia”
111
Daily dose
Check the electronic version!
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Daily dose All congress participants have now the opportunity to see in advance what is in the congress newspaper the Daily Dose. Stay tuned to your mailbox!
itter w T e h e in t Engag t #EAHP19 ea debat
SYNERGY EVENT: PREVIEW & SPEAKERS
Biosimilars in Haematology-oncology New Biosimilars again! What’s new about them in the field of haemato-oncology? Maybe you have asked yourself this question, and maybe you think that this Synergy seminar is not very important. However, it might be time to change your mind about the importance of biosimilars in haemato-oncology. When it appeared at the turn of the century, rituximab was a game changer in the treatment of multiple haematological diseases. It is now widely used in diseases such as lymphoma and some types of leukaemia as well as in rheumatoid arthritis. In hospitals which have a strong haemato-oncology component, rituximab is a major driver of drug expenses. And now biosimilars come to the market, so what
are the old questions that need specific answers? First, the question of interchangeability. Rituximab is often used in long term treatments, up to two years, and if we cannot switch between the reference product and the biosimilar, then uptake of biosimilars is going to be slow and the economic advantage is going to be minimal. To understand this, you have to consider the type of clinical trials that are behind the approval of biosimilars, and also how the drug works, so that arguments can have a solid scientific base. Second, is the issue of change in therapeutic trends. It is a well known fact that, whenever a drug is coming off patent, new and “better” alternatives will appear on the market. It may be a more practical route of administration, such
as rituximab subcutaneous, or it may be a new drug with the same mechanism of action, such as obinutuzumab. The whole point of having biosimilars is to allow cost savings that can be invested in new therapies for previously unmet needs. When these “better” options come to the market it is important to understand them clearly, and to change therapeutic trends only when the new drug has proven to be really better than the old one, otherwise the advantage of having biosimilars will mostly be lost. A finally, there is the issue of how to manage the change in the hospital pharmacy, from the work in the drugs and therapeutics committee to the procurement and logistic tasks that have to be
faced and resolved. All these questions are old ones, but with the appearance of new biosimilars, there is new blood to them, as the specific issues of oncohaematology have now to be considered. Come and learn from the experience of a haematologist, a clinical pharmacologist and a hospital pharmacist.
António Gouveia, EAHP Scientific Committee Member
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KEYNOTE 1 REVIEW: The OMNICS Approach - The buzz that makes the world go round
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t the 24th EAHP Congress, Prof Dr Gerhard F. Ecker, Professor of Pharmacoinformatics at the University of Vienna and Dean of the Faculty of Life Sciences, delivered the Keynote 1 speech on the spectacular evolution over the past 16 years of sequencing the human genome and the formation of the so-called OMICS technologies that form the basis of systems medicine (constructing therapeutic interventions based on a patient’s genomics or the mapping and editing of whole genomes, behaviour and environment). The aim was to give an overview of the present situation as well as the benefits these developments could have on pharmaceutical practices and patient outcomes since, in just a few days, omics-data can be turned into omics-guidance that can assist in delivering precision medicine. Sequencing a vast amount of genomes is what the personalisation of medicines is all about since it could lead to better research insights on diseases, targeted treatments and quick diagnoses. Pharmacists in particular would be able to see how the variations in a patient’s genome affect his/her individual response to a drug, better match patients with medicines, work out the best dose and, therefore, substantially improve pharmacogenomic practices.
analysed, interconnected and mapped must be expanded, especially when it comes to research funded through taxpayer money. The sensitive issue of patient data is mitigated by the fact that, through OMICS technologies, patterns are analysed, not personal information. There are a variety of tools that aim to guide those working in the drug sector navigate the data maze. The Open Pharmacological Space (OpenPHACTS) for instance allows pharmacists to answer complex research questions by integrating a vast array of data sources or KNIME which helps in putting different tasks together in a workflow that can be reused using different input. Prof Dr Ecker concluded by providing three take home messages. First, such OMICS technologies pave the way towards personalised diagnosis and treatment. Second, in order to reach its real potential, improving data integration and big data analytics skills and capabilities are key. Third, the new OMIC to look out for in the near future is microbiomics or how gut bacteria (first contact in terms of metabolising medicine) influence drug therapies. Valentina Dimulescu, EAHP Policy Assistant
Prof Dr Ecker continued by presenting the various types of OMICS technologies (transcriptomics, proteomics, metabolomics, single cell omics) that are presently being used in practice but not before revealing that he analysed his own genes and found a mutation, thus encouraging the participants themselves to interact with these novel technologies. The basic idea behind OMICS is that one would be able to see which genes present mutations and, even more, identify mutation patterns as well as patterns of variation associated with certain phenotypes. However, Prof Dr Ecker cautioned that patterns do not indicate that there is a causality. More analyses of these patterns and their careful classification are needed in order to infer a direct relationship and provide (early) diagnoses. Through computation and modelling a hypothesis is created and the latter needs to be scrutinised to reach the right therapy.
Mariona Ribó
An important aspect to consider is that the more these technologies are used, the cheaper they get. Nevertheless, funds are still needed in order to advance research in this respect and, considering that new and expensive medicines will be coming to the market, accurate and timely diagnosis will become even more important. Prof Dr Ecker also underlined that while the technology is available, timely access for specialists to the necessary data is still strained. For this point of view, the use of open research data that should be stored,
POLICY ARTICLE
Antimicrobial Stewardship Teams – the answer to fighting AMR
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n June 2018, the EAHP adopted its revised position on antimicrobial resistance (AMR) which puts the contribution of antimicrobial stewardship teams into perspective. Such teams which are still far away from being routine in European hospitals could help to alleviate the situation. Patients are not yet actively asking for the use of antibiotic stewardship teams in hospitals, however scientific results show their contribution to resistance development, the efficient reduction of antibiotic overuse and even cost savings. Consequently, the EAHP is demanding stronger uptake of the multi-professional approach to help with maintaining the efficacy of antimicrobial drugs and to prevent further spread of AMR. National governments and health system managers should better utilise the specialised background and knowledge of the hospital pharmacists in multi-professional antibiotic stewardship teams. However, not only stewardship teams are needed to combat AMR, but also universal application of infection prevention and control measures as well as vaccination is necessary. Existing toolkits such as the one for healthcare professionals in hospitals and other healthcare settings of the European Centre for Disease Prevention and Control (ECDC) should be used by hospital pharmacists to augment the uptake of prophylactic measures.
24th EAHP Congress
The position paper also underlines that an increased investment is needed to support the development of innovative proposals as well as arrangements for the maintenance of essential antibiotics are vital. Member States are consequently encouraged by EAHP to make the necessary arrangements that combat medicines shortages of existing antibiotics and that offer incentives for practice based research projects to investigate new fields of infectious disease control such as immunotherapy and to optimise the cost-effectiveness of systems for surveillance on antibiotic use and resistance. The ‘One Health’ approach of the European Commission’s action plan against AMR is a step in the right direction which also highlights the importance of the fact that measures in the human and veterinary sector as well as in the environmental field should complement each other. Further commitment is however needed to keep antibiotics working. Therefore, EAHP’s position paper highlights the need for governments to make arrangements that essential antibiotics will be maintained on the market with contingency stock level arrangements and alternative production by hospital pharmacists enabled where necessary. In relation to animal health, EAHP strongly supports regulatory oversight and proper implementation of measures in the veterinary and agriculture sectors at European, national
and local level. The revision of EAHP’s position on AMR was very timely and interlinked perfectly with the ECDC’s European Antibiotic Awareness Day (EAAD). The EAAD takes place every year on 18th November and is used to raise awareness about the problems linked to AMR. Last year’s edition promoted a new publication by the Organisation for Economic Co-operation and Development (OECD) titled ‘Stemming the Superbug Tide - Just A Few Dollars More’ which warns about disastrous consequences of AMR for public health. Data contained in this report revealed that 2.4 million people could die in in Europe, North America and Australia until 2050 unless further action is taken. To counter the problem the report lists five affordable policy solutions that could be implemented by governments. These include the implementation of stewardship programmes as one of the key suggestions. It is time to act now! EAHP’s position paper is a step in the right direction and will be used in the advocacy work of the Association to combat the growing threat of AMR.
27 th - 29 th March 2019 | Barcelona, Spain Personalised hospital pharmacy Meeting the needs of every patient
EAHP 2019 is available in app stores for IOS, Android devices and on the Web. Search for “EAHP2019” The EAHP2019 App is brough to you by Download the QR code reader to yout phone, open it
Stephanie.Kohl–EAHP Policy & Advocacy Officer
& you are ready to go!
24th Congress of the EAHP
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REPORT OF SYNERGY SATELLITE EVENT
The new buzz-word: Biosimilars
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The topic of this session was the procurement of biosimilars. For many years, biological drugs have not been subject to the competition of generics, but that has changed rapidly in the last 5 years. There were already several papers and sessions about the quality, safety and efficacy of biosimilars. However, these three items are assured by the same regulatory bodies that approve innovative medicinal product in Europe and they have
more than 10 years of experience with the registration of biosimilars. Therefore the price appears to be an important factor in the selection of these drugs. Three excellent speakers gave their views on this topic during the Synergy Satellite Event “Biosimilars – available yet sometimes missing – the challenge of procurement” (sponsored by an educational grant from Amgen), which led to some very interesting insights. Isabelle Huys stated that in 2019 more than 50 biosimilars will be authorised and available on the market. She further illustrated that there is an huge variance in the uptake of biosimilars between countries. She also underlined that we should be aware that not only the switch from originator to biosimilar is important, but also the switch back to the originator maybe necessary in some cases. Up till now there is only limited research done in this field.
Mariona Ribó
James Kent gave the perspective from the NHS experience with the biosimilar introductions. Important issues for biosimilar are the “first to market” and “winner first tender”. The NHS closely monitors the uptake of biosimilars in
the different regions and extracts the lessons learned from their experience. He specifically warned the audience about the new phenomenon “switch fatigue” which may become more and more noticeable as the number of biosimilars increase and which will diminish the savings. Armando Alcobia discussed his experience with the uptake of biosimilars in his hospital. He illustrated that not all biosimilar possibilities were implemented for several reasons. He compared the mg price of these biological products (2 euro per mg) with the mg price of gold (0.36 euro per mg), which was an eye-opener for the audience. The bottom-line of a drug class is normally reached when there are 5 or more competitors available on the market. He predicts that automatic substitution will appear in the near future. Finally he warned the audience that within the next few years shortages of these drugs will become an important issue. When closing his presentation, he pointed out that hospital pharmacists should try to prevent shortages from happening and that the problem of shortages should play an important role in the way drugs are being tendered at the moment. Hugo van der Kuy, Associate Editor, European Journal of Hospital Pharmacy
Crossword Puzzle
ACROSS
1. What is KRZ specialized in – come to stand 29 6. AMiS contributes to: secured medication logistics, safe medication administration and … 7. The answer to suppress now the progression in Multiple Sclerosis. 11. Grifols city of origin. The answer in booth 3! 12. Exhibitor with Fulvestrant that can be stored at room temperature. 17. What is the name of the product that ensures safest medication management in the operating theater? Check Booth #4 21. IMI’s core products help protect drugs from? 22. GPIs must be linked to EAHP _ _ _ _ _ _ _ _ _ _ 23. You can find the answer in booth number 24. 24. What is the name of the MedXL syringe filling device?
Complete one of the crossword puzzles included in the Wednesday and Thursday Daily Dose, bring it to the EAHP booth #32 and enter a prize draw to win a free registration for the 25th EAHP Congress in Gothenburg (25 – 27 March 2020). Name: Complete the crossword below 1
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2. What is B. Braun’s new IV Ready-To-Use product in multimodal analgesia? 3. The only official journal of the European Association of Hospital Pharmacy. 4. It’s what RX Source do best. 5. How many new products is Baxter introducing at EAHP? 8. What colour are the ENFit syringes supplied by NeoMed for light sensitive medications. 9. 25th EAHP Congress is taking place in _ _ _ _ _ _ _ _ _ _. 10. Dedalus’ compounding system for antineoplastic drugs at booth 69. 13. STechnoflex is located in a surfer’s paradise. 14. Who produces the BNF, Martindale and Stockley’s Drug Interactions? 15. 25,000 + healthcare professionals trust ? to access medicine. Stand 52. 16. Pfizer Infliximab [Please see https://www.ema.europa.eu to access European centrally approved SUMMARY OF PRODUCT CHARACTERISTICS.] 18. Which is the country with the highest absolute number of 99 complete responses in the 2018 EAHP Statements Survey? 19. Company that’s changing healthcare with the Autonomous Pharmacy, booth 17 20. Which inspection system is JVM Europe showing?
FULL NAME: EMAIL:
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Created using the Crossword Maker on TheTeachersCorner.n
Across 1. what is KRZ specialized in – come to stand 29 6. AMiS contributes to: secured medication logistics, safe medication administration and … 7. The answer to suppress now the progression in Multiple Sclerosis. 11. Grifols city of origin. The answer in booth 3!
Down 2. What is B. Braun’s new IV Ready-To-Use product in multimodal analgesia? 3. The only official journal of the European Association of Hospital Pharmacy. 4. It's what RX Source do best
24th Congress of the EAHP
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BIOSIMILARS
challenging misconceptions, optimising uptake, maximising value 24th Congress of the EAHP 27-29 March 2019, Barcelona, Spain
WEDNESDAY, 27 MARCH 2019 17:00 TO 18:30 > ROOM 116 THURSDAY, 28 MARCH 2019 13:30 TO 15:00 > ROOM 116
FINANCIAL SUPPORT WAS PROVIDED BY PFIZER LIMITED AS A MEDICAL AND EDUCATIONAL GOODS AND SERVICES
POLICY ARTICLE
CTF Meeting between the EAHP Board and National Competent Authorities
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he first CTF Meeting between EAHP representatives and competent national authorities was held in Barcelona on Tuesday 26th March. EAHP took this opportunity to introduce the Common Training Framework (CTF) project to the competent national authorities present at the meeting. EAHP and its 35 member associations are currently working to create a Common Training Framework for hospital pharmacy. The Common Training Framework (CTF) is a legal tool that will help hospital pharmacists to achieve automatic professional qualification recognition across EU countries, meaning that learning outcomes and competencies received in one European country are recognised throughout the Union. National competent authorities for 12 different countries were present at the meeting which was also attended by the EAHP Board and representatives from different CTF Working Groups.
EAHP President Petr Horák started the meeting by introducing the project to national competent authorities and explained the reasons why EAHP is working to create a CTF. The overriding motivation for creating a CTF for hospital pharmacy specialisation is “to enhance the quality of, safety of, and equity of access to, patient care in every European country” which as Petr Horák explained lies in the centre of all discussions linked to the development of the CTF. Petr Horák’s introduction to the project was followed by a presentation on the Spanish Hospital Pharmacy programme made by Ana Lozano (SEFH Vice-President). Ana Lozano gave an overview of the hospital pharmacy programme in Spain, one of the oldest European programmes set up in 1977. She also highlighted the different benefits of having a CTF for hospital pharmacy such as raising the standards of the profession in Europe and improving the exchange of knowledge and expertise between countries.
The Falsified Medicines Directive (FMD) – EAHP’s members take stock
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The EAHP, through its national member associations, has supported these processes and facilitated the implementation of the FMD in the hospital pharmacy sector by sharing evolving information about the progress of the project and best practices. Despite these efforts, external factors delayed the progress in some countries, not only for hospital pharmacists. Consequently, many national competent authorities opted for the application of a stabilisation period to allow all actors to become compliant. In accordance with this piece of legislation, hospital pharmacists are under legal obligations to conduct verification scans for each package of medicine received by the hospital and dispensed to a patient. 6 weeks after
More details about the CTF project can be found at www. hospitalpharamcy.eu The EAHP team
Cyber Café
POLICY ARTICLE
n 9th February 2019, the Delegated Regulation laying down detailed rules for the safety features appearing on the packaging of medicinal products for human use entered into force. Hospital pharmacists around Europe have worked hard in the past two years to upgrade their IT systems in order to be able to scan the unique identifier on each pack. Logistic processes have been adjusted throughout the 29 participating European Economic Area countries to incorporate FMD as efficiently as possible.
The meeting ended with a round of questions and an open discussion moderated by EAHP President Petr Horák. National competent authorities and EAHP representatives engaged in a positive and fruitful discussion on how we can work together to make CTF a reality within Europe to improve patient outcomes. Attendants agreed on the importance of working together and on close engagement while the project is progressing.
Fill in the Evaluation Forms of the sessions you attended to receive your ACPE accreditation certificate and Certificate of attendance.
the implementation of the FMD, EAHP took stock with its members. The meeting was opened by a presentation of EAHP Director of Professional Development Rob Moss who shared insights on the implementation progress from a European perspective. Each EAHP member association was provided with the opportunity to present information on the current status of FMD implementation in their country. The attendees reported that (almost) all hospital pharmacies have been connected to their National Medicines Verification System and that software and hardware equipment has been put in place. The alert level is remaining high and many are experiencing technical alerts. Aggregation was mentioned as a solution to coping with large numbers of medicinal products by the participating countries.
Also register during the Congress for the Synergy Masterclass 2019 to get 10% discount at the Cyber Café
As detailed by EAHP’s member associations during the meeting, the FMD most certainly has an impact on logistics in the hospital setting. However, all involved actors, including national competent authorities and the National Medicines Verification Organisations, are dedicated during the ramp-up phase to minimise the impact of technical issues on hospital logistics.
FREE WI–FI SERVICE WILL BE AVAILABLE THROUGHOUT THE CONGRESS CENTRE AND IN THE CYBER CAFÉ SPONSORED BY
Stephanie.Kohl, EAHP Policy & Advocacy Officer
WiFi network name: EAHP_ROCHE Password: ROCHE2019
24th Congress of the EAHP
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REPORT OF SYNERGY SATELLITE EVENT
ANTICOAGULATION
IMPROVING EFFICACY AND PREVENTING SIDE EFFECTS – SPONSORED BY AN EDUCATIONAL GRANT FROM BAYER –
Wednesday, 27 March 2019 / 14.45 to 16.15 / room 116 Thursday, 28 March 2019 / 08.45 to 10.15 / room 116
24TH Congress of the EAHP, 27-29 March 2019, Barcelona, Spain
Anticoagulation – improving efficacy and preventing side effects Lorenz van der Linden (Leuven) showed that 1% of the population is taking anticoagulants. People over 40 years of age have an increased risk of atrial fibrillation. Overall, there are three health conditions that need anticoagulation treatment: 1) atrial fibrillation; 2) venous thrombo-embolic disease and 3) mechanical valve prothesis. These patient groups will have to use anticoagulation medicines for the rest of their lives. Atrial fibrillation (AF) is the most common type of arrhythmia. It is irregular in frequency and the ECG shows no P-tops. Statistically, 1 in 4 people who are over 40 will receive an AF diagnosis. They will have a 20-25% increased risk of such events. However, by using anticoagulants, this risk can be reduced by two thirds! Due to potential hospital procedures, 1 in 10 patients will have to interrupt their anticoagulant therapy. Usually, a full heparin bridging was given before and after the procedure . The American College of Cardiology has put together a consensus on when and how to intervene and stop the anticoagulant therapy before the procedure and if indicated, after the procedure. The decision whether to bridge or not to
bridge depends mostly on the risk of bleeding. In general, when using NOAC’s you will not need to do any bridging. If the patient uses Vitamin K antagonists (VKA), bridging depends on the risk. When the risk is low, no bridging is needed, but when risk is high, bridging is needed. In all cases, no full anticoagulant therapy is given 24 hours before the procedure until 24-72 hours after. NOAC’s should always be interrupted. VKA discontinuation before the procedure depends on the half-life of the drug: 3-4 days with acenocoumarol and 7-10 days with phenprocoumon. Anticoagulant therapy should be restarted during the patient’s hospital stay after 24-72 hours. Charlotte Quintens (Leuven) explained the hospital anticoagulant stewardship. How can the hospital pharmacist attribute to avoiding adverse drug events (ADE) in anticoagulation therapy? ADE’s are present in 6% of all hospitalisations, out of which 50% are avoidable, according to a HARM study. Hospital pharmacists should check the Medical Appropriateness (CMA) for potentially inappropriate medications (PIM) in the back office.
How does CMA work? First, you have to identify patients with PIM. Then you formulate clinical rules for it, incorporating the incorrect dose, lab results and patient characteristics. Next, you fully screen for the CMA and validate the findings. Finally, intervene by electronics or phone to the prescriber. It was shown that, in NOAC therapy, inappropriate use was seen in 60% of patients. With, of course, an important fatal risk. Several conditions are needed to implement the check. Hospital pharmacists should involve the cardiology department, the hospital board, the P&T committee, the Ethics Committee and the IT services. Hospital pharmacists can play an important role in anticoagulant stewardship!
Dr. Berry van Schaik
EAHP warmly thanks our industry partners for their continued commitment to supporting the goals of hospital pharmacists.
PLATINUM PARTNERS
GOLD PARTNER
CORPORATE PARTNERS
KEYNOTE 3: PREVIEW & SPEAKER BIO
Inequalities in European health systems - economics versus access
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rof. Dr. Reinhard Busse studied medicine in Marburg, Boston and London. He obtained a Master in Public Health in Hannover, Germany. After his PhD he qualified as a professor in the field of epidemiology, social medicine and health services research. Prof. Dr. Busse is the head and founding member of the Berlin Centre for Health Economics Research (BerlinHECOR). In addition, he is heading the Department of Health Care Management in the Faculty of Economics and Management at the Berlin University of Technology. He is also a faculty member of ‘The Charité’, Berlin’s university hospital. His keynote will address two problems – accessibility and affordability. The problem of accessibility Accessibility of drugs is connected to different factors. Access can be influenced by health legislation, by patient centred factors, like having a retail or hospital pharmacy within reach or getting a prescription, or by factors linked to the pharmaceutical industry, like drug shortages or even producing or re-inventing a certain drug. Given this diversity of factors measures to solve the problem of the non-accessibility of drugs differ. If for instance a drug is not accessible because it is not being
licensed by national health systems (at local and/or national level) the problem solving measures clearly lie in the hands of legislative bodies.
individuals, nations and regions due to economic power, legislation, existing guidance and guidelines as well as regulations in health care systems.
The problem of affordability
The keynote will sensitize us for those problems and it will perhaps also give us some hints for problem solving.
It is absolutely clear that if you cannot afford a drug you will not get it. This statement underlines a major problem for individuals – namely the problem of affordability which is influenced by out-of-pocket costs or co-payments as well as by national health systems themselves in an era of impoverishment in certain regions. Even in wealthy countries measures to regulate the expenditures for drugs are in place (e.g. NICE in the United Kingdom). Therefore, sometimes accessibility and affordability are interconnected. If for example a country thinks that a drug is too expensive for the national health system the country tends to limit the access to this drug, either for all or for a variety of patient groups. Access to a drug in those cases is possible only if a certain patient or a patient group qualifies for exemptions included in guidance documents or guidelines. At the end of the day (non-) accessibility and (non-) affordability lead to the same result. There will be inequalities between
Torsten Hoppe-Tichy – EAHP Scientific Committee Member
K E Y N OTE
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FO R U M AUDITOR IU
Prof. Dr. Reinhard Busse, head and founding member of the Berlin Centre for Health Economics Research
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Friday 29 March 11.30 - 13 .00
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