Daily Dose Post-congress edition 2018

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KEYNOTE 2 REVIEW We have a dream!

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WINNER’S CORNER Page 5

KEYNOTE 3 REVIEW Mariona Ribó

Thank you for attending the 23rd Congress of the EAHP ”Hospital pharmacists: show us what you can do!”

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hank you for attending the 23rd Congress of the EAHP ”Hospital pharmacists - Show us what you can do!”, the central annual event for anyone interested in hospital pharmacy education and development .

Three keynotes focusing on global health, marketing and the profession itself drew 3400 hospital pharmacists to the second largest city in Sweden. Workshops, seminars and EAHP’s synergy programme - which featured 5 synergy satellites on biosimilars in cancer and breast cancer care, biologics, anticoagulation and automation - rounded off the three-day event.

The scientific programme was built around the 44 European Statements of Hospital Pharmacy which express commonly agreed objectives that every European health system should aim for in the delivery of hospital pharmacy services. To better monitor the uptake of these Statements and to help EAHP national associations to move towards

Statement implementation on the national level, the EAHP implementation team launched the Self-assessment tool and the Statement Implementation Learning Collaborative Centres (SILCC) programme. The online Self-assessment tool will allow hospital pharmacists to assess the level of implementation of the Statements within their hospitals, while the SILCC programme will provide hospital pharmacists (SILCC Fellows) with the opportunity to visit hospitals (SILCC hosts) from other EAHP member countries to learn about pharmacy procedures linked to the European Statements of Hospital Pharmacy. With the help of both of these tools, the EAHP hopes to improve patient outcomes throughout Europe.

Thank you all for coming to Gothenburg and choosing the EAHP Congress for your networking and learning. See you next year in Barcelona!

Marketing the hospital pharmacy profession Page 7

EAHP warmly thanks our industry partners for their continued commitment to supporting the goals of hospital pharmacists

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Crossword Puzzle Winner!

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NOBI LI

Thank you for completing the crossword and participating in it.

YOU WON A FREE REGISTRATION FOR THE 24TH CONGRESS OF THE EAHP IN BARCELONA!

Mariona Ribó

Mariona Ribó

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KEYNOTE 2 REVIEW: We have a dream!

Cheryl McKay and Jonathan Underhill sharing their dream for the hospital pharmacy profession

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heryl McKay & Jonathan Underhill took the EAHP 2018 participants on a journey through their dream for the hospital pharmacy profession. In a role play inspired

by Charles Dickens’ Christmas Carol, hospital pharmacist Jonathan was visited by the ghosts of pharmacy past, pharmacy present and pharmacy future. After each dream, Jonathan met with his hospital manager Cheryl who has a nursing background and was newly appointed to discuss his thoughts and his concern about one particular patient, 84-year-old, Betty.

In his first dream, Jonathan heard from the ghost of pharmacy past which highlighted the different achievements of the profession to him. Pharmacists have greatly contributed to the protection of the public from unsafe and unproven medicines as well as to the rarity of dispensing errors. Moreover, the ghost of pharmacy past highlighted the skills of pharmacists which are excellent for the procurement and supply. In his conversation with Cheryl, Jonathan pointed out that his patient Betty is currently taking 13 different medicines to treat the 7 different illnesses with which she was diagnosed. However, Betty is not taking her medicines. Cheryl raised her concerns that Betty could end up in the hospital if the situation of not taking her medicines continues. Jonathan promised to have a think about Betty and to follow up with Cheryl during their next meeting.

The ghost of pharmacy present highlighted challenges in

pharmacy and medicines optimisation to Jonathan which included information overload, the cognitive biases in decision making, problematic polypharmacy as well as shared decision making. During his conversation with

Mariona Ribó

Cheryl he addressed these challenges and highlighted the advances made through the implementation of the European Statements of Hospital Pharmacy as well as national initiatives undertaken in Italy, Sweden, Bulgaria and Romania linked to the Statements. In addition, he explained how different projects carried out in Spain, Ireland, Austria, Norway and England are trying to address the challenges in pharmacy and medicines optimisation. In regard to Betty’s conditions, Jonathan and Cheryl discussed the importance of adequate prescribing including the advantages and disadvantages of giving anticoagulants to Betty.

Before his last meeting with Cheryl, Jonathan was visited again, this time by the ghost of pharmacy future who showed him how pharmacists are leading the way in shared decision making around medicines. During his dream he realised that good consultation skills are vital for hospital pharmacists and that they should be practiced and better developed in a safe environment in which feedback is provided. In their conversation Cheryl and Jonathan spoke about the great examples of the Northumbria Shine Care Homes Project and the World Health Organisation’s Patient Safety challenge. Moreover, Jonathan mentioned the possibility of using avatar technology to practice conversation skills. Engaging in a conversation with Betty helped him in finally finding out why Betty was not taking her medicines.

At the end of their talk Jonathan and Cheryl evaluated the options for the way forward. In essence they agreed that pharmacists have a unique skillset that should be actively used by involving them in planning and delivering medicines optimisation to patients. The European Statements of Hospital Pharmacy are a powerful enabler to achieve this goal.

Stephanie Kohl – EAHP Policy Officer

Student programme

An evidence based approach to developing an individualised patient care plan

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n order to support student engagement in hospital pharmacy, a student session was organised during the Congress in Gothenburg. The session revolved around the theme “An evidence based approach to developing an individualised patient care plan”. It was delivered by Dr Antonella Tonna and Dr Kathrine Gibson Smith and facilitated by Prof Branislava Miljković, who is an EAHP Scientific Committee member.

The session was split in two parts – in the first part comprising out of a short presentation on data gathering was given by Dr Tonna, who also presented ways to collaborate with the patient in order to receive the best information from them and help them to the best of our ability. The collaboration with other medical professions was also mentioned and encouraged as well. The sources of medical information, such as the patient and medical records, were discussed and participants were invited to utilise them in the first practical exercise. All the groups were to propose as many possible sources as they could think of, and present advantages and shortcomings of each of them. The group work ensured that the participants got engaged and were able to discuss their ideas with each other.

After that, the participants received the task to review an actual patients’ information and medication history, together with their current drug therapy plan and laboratory test results of certain parameters. The task was to review the current drug therapy, together with all the parameters provided, and propose possible improvements to the therapy which would increase the benefit to the patient, while mitigating possible side effects. The task was very engaging and it initiated good discussions about possible improvements and their advantages.

The second part of the session was focused on acquainting the participants with scientific literature by presenting to them the ways in which it can be read and, specifically, reviewed. Dr Gibson Smith made the participating students

familiar with the CASP Tool, which is a systematic tool used to review scientific articles. To practice their newly acquired skills, students were given a scientific article together with an evaluation form following the CASP Tool. Through exchanging the opinions of the participants, the article was evaluated and reviewed part-by-part. This exercise provided students with insights into how the process of reviewing looks like, and which questions come up in reviewer’s heads when reading an article.

The session was very interactive, with input from students being given very frequently. The ways of conducting a medication review and communicating with patients were also presented via shorter videos, which made it easier for students to remember them and utilise them in the practical part of the session. The group work also needed to be presented, which provided the participants with the opportunity to do some public speaking as well. All in all, the students that joined the session benefited greatly from getting in touch with the scientific world and being lead through a reviewing process, using the CASP Tool, as this is something not many students are familiar with. Črtomir Fleisinger – EPSA President Mariona Ribó

EJHP - Hands on medicines information The ‘Hands on medicines information’ section of the EJHP aims at presenting clinical queries arising from medicines information practice, in particular those that are complex or unusual and could be of interest to other hospital pharmacists.

Hospital pharmacists are encouraged to send submissions for this EJHP section. They should present a clearly defined clinical question and answer which should be supported with scientific evidence. The inclusion of patient-specific information and an outcome assessment is strongly encouraged.

Submissions should be structured in the following manner: •

Summary of up to 150 words;

•

Introduction, including the case presentation and any clinical or background information relevant to the query;

•

Clinical question;

•

Recommended answer, including the problemsolving approach used (if applicable);

•

Outcome and discussion; and,

•

Key message/learning outcome of one sentence.

The article should be no longer than 1500 words, include a maximum of 1 table and/or figure and up to 10 references. It can be uploaded via the ‘submit a paper’ button on the EJHP website (http://ejhp.bmj.com/).

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REPORT OF SYNERGY SATELLITE EVENT

The power of automation

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he power of automation’ was held on Thursday 22nd March during the second day of the 23rd Congress of EAHP in Gothenburg. The session featured an interactive voting system, allowing participants to test their knowledge, comparing their answers with other participants in real time. The same questions were presented again after the sessions, allowing participants to re-think their answers based on the lessons learned.

The Synergy session began with the first presentation, by Gillian Honeywell titled ‘Automation: Can we realise benefits for patient safety?’ which introduced participants to key considerations regarding automation: what is the cost, how will staff be affected, and how much money can be made.

The presentation demonstrated that automation has many variants; from barcode scanning to automatic dispensing cabinets, and even drone transport systems, highlighting one of its’ main innovations; electronic prescribing systems, which integrate a stock system, a robot/carousel, and an electronic medicine cupboard, allowing safety features such as fingerprint activation. Benefits from these innovations are directly linked to patient safety, as they increase the time a hospital pharmacist can spend on clinical duties such as interacting with doctors or helping patients understand their medications. There are however some limitations, such as the dependency on the network and power, interoperability, and human error in selecting from dropdown menus.

Gaëlle Henneré shared experiences from an automation case study that was carried out in a general French hospital during her presentation ‘Electronic dispensing Cabinets in a general French hospital: 15 years’ experience feedback’.

The hospital itself includes an obstetric surger y medicine ward as well as a general one, with the unique condition of

Mariona Ribó

being connected to a prison, servicing 1000 inmates.

The automation project began in 2003, and included the introduction of electronic dispensing cabinets, which were adapted to OSM prescriptions, making treatments available 24 hours a day, allowing total traceability and optimising stock management. The results of this automation were a reduction of errors, from a previous 3% to a current 0.6% after full implementation, and a reduction of 0.8% prescription error with a non-computerised method to a 0.2% computerised prescription error.

The last presenter, María José Tamés, spoke about ‘Transitioning from manual to automated chemotherapy compounding, the main issues to consider’. Her presentation focused on the added value of automated compounding; ranging from patient and operator safety, to accuracy, microbiological quality and traceability. During her talk she highlighted the fact that any compounding error can have serious consequences, from the failure of a treatment to the death of a patient. In this regard, robot compounding can both reduce errors and preparation time, however requiring a reorganisation of the workflow in order to anticipate needs and preparation time.

Participants were ver y engaged throughout the presentation, and the dynamic voting system demonstrated the educational value of the presentations in real-time.

SELF-ASSESSMENT TOOL & SILCC PROGRAMME

Two initiatives, one goal: moving towards Statement implementation

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he 23rd EAHP Congress in Gothenburg saw the launch of two exciting EAHP initiatives: the online Self-Assessment tool and the Statement Implementation Learning Collaborative Centres programme (SILCC).

More than 200 participants stopped by the EAHP booth during Congress to learn more about these exciting new initiatives that are linked to the European Statements of Hospitals Pharmacy and the Statement Implementation project. EAHP is working with its national associations to move toward the implementation of the European Statements of Hospital Pharmacy within all EAHP member countries.

sathp Self-assessment tool for hospital pharmacists

The Self-Assessment tool allows hospital pharmacists to assess the level of Statement implementation within their hospitals. In addition, the tool will provide the means for hospital pharmacists to address the areas needing improvement with a tailor-made action plan and evidence-based resources.

By assessing their hospital pharmacies, hospital pharmacists will not only be able to understand the statement implementation level within their hospitals, but it will also

help them understand where they are within their own countries and others. The self-assessment tool will also complement the information EAHP has been collecting through our regular surveys.

EAHP also launched during Congress a high quality video explaining how the self-assessment tool can be used to move towards the implementation of the European Statements. The video can be found here.

Assessing your pharmacy with the tool is one of the key requirements to apply for the SILCC programme. The tool is already translated to 7 different languages and can be found at: http://sat.eahp.eu/en/home.

silcc Statement Implementation Learning Collaborative Centres

In addition to the self-assessment tool, EAHP also launched the SILCC programme.

The SILCC programme is a new initiative that will allow hospital pharmacists to visit hospitals from other member countries while learning pharmacy procedures linked to the Statements. EAHP is providing a

Mariona Ribó

reward system for SILCC Hosts (hospitals providing training) and limited financial help for SILCC Fellows (hospital pharmacists receiving the training).

EAHP is working with its national associations and national implementation ambassadors to keep moving towards the implementation of the European Statements of Hospital Pharmacy within EAHP member countries. A lot has happened since the project was approved during the 46th General Assembly in June 2016. EAHP has already progressed numerous items included in the updated strategic plan: from updating our awareness campaign to start designing national implementation strategies. All relevant

information about the project, including all the progress made, can be found in our website: www.statements.eahp.eu Do you want to learn more about the European Statements of Hospital Pharmacy?

DO you have questions about the Selfassessment tool? Do you want to be part of the SILCC programme? Do not hesitate to contact the EAHP Implementation team at Statements@eahp.eu and don’t forget to subscribe to the Statement Implementation newsletter.

EAHP Implementation Team

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REPORT OF SYNERGY SATELLITE EVENT

Biosimilars in cancer care – the next challenge

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ne of the Synergy Satellite Events taking place at the 23rd Congress of the EAHP was Biosimilars in cancer care - the next challenge. The clinician’s perspective on biosimilars, the robustness of the regulatory process in assessment of biosimilars, and a real-life example from Sweden on the impact of biosimilars on cancer care were presented and discussed. The session was moderated by EAHP Scientific Committee member Juraj Sykora.

Dr Rosa Giuliani, affiliated with the European Society for Medical Oncology (ESMO), pointed out that due to the differences from drugs, specific education is needed when making clinical decisions about biologics. Due to the massive revolution in treating oncology, clinicians are facing a lack of information. With biologics, the analytical data is needed to determine similarity of a biosimilar instead of improvements. She also highlighted the procedure is of the same length as for originators. Dr Giuliani continued by stressing that when properly developed, biosimilars contribute to the accessibility of healthcare and provide an opportunity to increase access to drugs and reduce the cost of treatments. She concluded that in order to build confidence in prescribing biosimilars, access to data about them is needed, together with strong guidance of healthcare professionals with interaction and collaboration at different levels. All of this will provide real world evidence to facilitate the use of biosimilars.

The second speaker, Dr Paul Cornes, affiliated with the Comparative Outcomes Group, continued by stating that biosimilars are approved by evaluating a data package – analytical, non-clinical, and clinical trial data. Molecules

in living systems have an inherent variability, microheterogeneity, which does not affect their properties in any major way, but is important to keep in mind for manufacturing of biosimilars, as it provides a reference. Modern analytical methods are more than capable of detecting that variability and ensuring it fits in the reference.

Clinical trials are still important, to check residual uncertainties, and are not uniform for biosimilars. He then followed-up on switching, labelling, and extrapolation. He explained that switching between brands could lead to immunogenicity, however enhanced immunogenicity was not yet observed.

For the labelling, different methods are used in Japan, US, and Europe – they all work, but the same method needs to be used in the hospital and health centre. Regarding extrapolation, he pointed out it is already being done and is supported by science. In conclusion, biosimilars work, but lack of access is an issue because of price, however clinicians need help in education about biosimilars in order to get the knowledge on how to prescribe these drugs, as this is a condition for the system to work.

Lastly, Mr Gustaf Befrits elaborated on a case from Sweden and the economic impact it had. There are quite a few biosimilars on the market. He presented the case of infliximab biosimilar entering the Swedish market and the strategy to ensure high uptake of the biosimilar, through a single winner tender, ran by the authorities, while Norway

Mariona Ribó

and Denmark already switched to biosimilar. That gave doctors and patients information. Consequently, the switch to the next biosimilar (etanercept biosimilar) that came to the market was doctor-driven, because of massive cost decrease seen from the previous one. In Sweden, the money saved is used to introduce more expensive treatments.

The total expenditure was still increasing, because of the increasing prices of medicines. The conclusion was that education mattered considerably in introducing biosimilars to the market, and competition needs to be introduced in order to ensure best savings and access. In one situation, after the introduction of a biosimilar, the originator reduced the price of their biologic to such an extent that it was cheaper than the biosimilar. The session was financially support by Pfizer Limited as a Medical and Educational Goods and Service. Črtomir Fleisinger – EPSA President

POLICY ARTICLE

The One Health approach – a new tool in the fight against AMR

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hose of you that attended the seminar ‘Antimicrobial stewardship - Growing a positive culture’ might have heard about the rising importance of stewardship teams in the fight against antimicrobial resistance (AMR).

Also, the European Commission highlighted again that continued action is needed to address the AMR problem.

To this end, the ‘EU One Health Action Plan against AMR’ was adopted in late June 2017 to better address the major European and global challenges that AMR poses. The key objectives of this action plan centre around 3 main themes: 1. Making the EU a best practice region 2. Boosting research, development and innovation 3. Shaping the global agenda.

The themes contain 75 concrete actions that should be tackled by 9 different Directorate-Generals in the coming years. Progress has already been made in the past year through the adoption of the EU guidelines on prudent use of antimicrobials in human medicine, the launch of Horizon 2020 work programme for 2018-2020, a joint paper of the Transatlantic Taskforce on Antimicrobial Resistance (TATFAR) partners on incentives for antibacterial drug development as well as AMR cooperation activities with India on veterinary medicinal products and South-American countries to name a few.

The one health approach of the European Commission’s new action plan for the first time also encompasses environmental aspects on AMR in addition to actions in the human and the veterinary sector. The expansion of scope was crucial since the environment was identified as a link between humans and animals and likewise a potential source of new resistant microorganisms. The DirectorateGeneral on Environment (DG ENVI) is currently developing a strategic approach to pharmaceuticals in the environment which will be published in the course of 2018. To this end European stakeholders – such as EAHP – and the public were invited to input during a targeted and a public consultation.

The feedback provided via both consultations will feed into the Commission Communication detailing the strategic approach for pharmaceuticals in the environment.

Besides the European Commission also the European Centre for Disease Prevention and Control (ECDC) actively promoted the fight against AMR over the past month. In October 2017, the ECDC released a new toolkit for healthcare professionals in the hospital sector which contains materials to help them influence the use of antibiotics in their work environment. The factsheets, infographics, posters and leaflets can easily be adapted by prescribers, nurses and hospital pharmacists that would like to do more in their hospital to keep antibiotics working. The EAHP – who has also contributed to the hospital toolkit of ECDC – is currently

working on an update of its statement on AMR. Make sure to keep an eye on our social media accounts as well as the EU Monitor to stay up-to-date on AMR in the coming months.

Stephanie Kohl – EAHP Policy Officer

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WINNER’S CORNER

Meet the winners of the 23rd EAHP Congress Poster and GPI prizes

During the 23rd EAHP Congress, 8 award nominees gave oral presentations on Wednesday March 21 and 8 other authors had the chance to give a presentation with feedback provided by the Scientific Committee members during the Poster Walk.

This year we have received almost a thousand abstracts submitted by hospital pharmacists from around the globe. All accepted abstracts were hung in the poster area and published in the abstract book. Authors were also provided an excellent opportunity to present their work to colleagues interested in their field of expertise.

Here’s a glimpse of the number of abstracts received vs abstracts accepted over the years:

Received

Accepted

Paris 2013

950

630

Barcelona 2014

877

525

Hamburg 2015

880

535

Vienna 2016

889

571

Cannes 2017

1053

607

Gothenburg 2018

988

529

Mariona Ribó

The EAHP Congress poster exhibition and the oral poster communication sessions are the mainstay of the 1st Prize for the Good Practice Initiatives went to Kim Florean Green for the annual EAHP Congress and only the best are selected! abstract and poster entitled “Algorithm to develop an essential drug list”

Mariona Ribó

1st Poster Prize went to Xènia Fernández-Sala for the abstract and poster entitled “Linezolid dosing in patients with liver cirrhosis: standard dosing risks’ toxicity”

Mariona Ribó

2nd Poster Prize went to Clementine Richard for the abstract and poster entitled “Design and implementation of a pharmacy technician training programme to improve outpatient drug dispensing”

Mariona Ribó

3rd Poster Prize went to Per Nydert for the abstract and poster entitled “Best practice of ward-based reconsitution in paediatric hospitals”

Abstract submission deadline for the 24th EAHP Congress is 15th October 2018 Do you have a Good Practice Initiative that you would like to share?

Visit the website www.eahp.eu/gpis and tell us about your GPI. The submission portal is open all year long!

to inspire and encourage fellow hospital pharmacists in other countries to strive for the next high standard in practice

to give recognition to those who have completed successful new initiatives in hospital pharmacy service

VISIT THE GPI’S PORTAL AND DATABASE AND TELL US ABOUT IT! WWW.EAHP.EU/GPIS

to identify how colleague hospital pharmacists were able to overcome barriers and obstacles in order to make improvement happen

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Report - The essentials of biologicals: past, present and future

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he Synergy Satellite event on biologics covered three essential elements, namely the production of, the pharmacoeconomics of and the tendering of biologics. The first aspect was discussed by Harald Sitte who is working at the Centre of Physiology and Toxicology in Vienna, Austria. He explained the difference between biologicals and biosimilars by stating that biologicals are compounds made by bio-organisms, nowadays recombinant.

He highlighted that mass production of biologicals starts with a cell line that will grow to a protein. This development takes 9-18 months and is therefore rather expensive.

Purification of the protein is done by electrophoresis. The glycosylation of the protein was mentioned as an important Mariona Ribó

step that needs to be carried out for biological activity, ligand binding, avoidance of immunogenicity, clearance and stability. Prof Dr Sitte emphasised that the end product shows slight differences between badges of production due to the cell line differences. Therefore, after licensing, the production of the protein can evolve to a better product.

The glycosylation can further differentiate the end product.

In relation to immunogenicity he pointed out not only the structure of the protein and glycosylation, but also the patient, the formulation, the route of administration, the dose and many other aspects can have an influence. He closed his presentation by underlining again that biosimilars are copies of the originator with small structural differences in product, activity and stability. Consequently, differences and divergencies in evolution need to be monitored.

Steven Simoens, a health economist from Leuven, Belgium, introduced the audience to the pharmacoeconomics of biologicals. He presented a review of 15 studies about cost-effectiveness of biologics in rheumatoid arthritis. A combined biologic and non-biologic DMARD was compared to a non-biological DMARD. Mean cost-effectiveness of the biological was calculated as $ 47.500 per QALY, with a range of $ 5.000 to $ 230.000 per QALY. Prof Dr Simoens highlighted that cost-effectiveness will develop during the life cycle of

the biological. The budget impact is not only depending on the price reduction, but also on accessibility and continuous innovation. In Belgium, the use of biosimilars is stimulated by a bonus, given to physicians, if they prescribe biosimilars.

Per Troein, Vice President of Strategic Partners at IQVIA addressed leveraging biosimilars for better access and lower costs. Globally, drug expenditures are over $ 964 Billion at the moment. This figure increased over the last 5 years by 6.4%. The share of biologicals is about 25%, while biosimilars account for only 1% of the total. Many savings are to be expected in the next few years. At this moment 40 pharmaceutical companies explore the marketing of one or more biosimilar medicine. Mr Troein expects a decrease in expenditure, a greater accessibility and new innovations.

He showed that great differences in price are apparent between countries, as well in list prices as in net prices. The effect of tendering is strongest in Norway, however, there are risks to tendering as too few companies are ready to compete in tenders. Furthermore, he pointed out that drug shortages due to rapid switching or production problems could become an issue as well as the long-term sustainability. Mr Troein closed is presentation with an outlook on the role of the hospital pharmacist.

Dr. Berry van Schaik

EAHP’s annual member gathering at Congress and a heated discussion on FMD

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s reported in the Thursday edition of the Daily Dose, the EAHP dedicated its first day of Congress to two important member activities, the annual members’ meeting and a meeting with the European Commission on the Falsified Medicines Directive (FMD).

EAHP’s annual members’ meeting Each March, the EAHP makes room in its very busy Congress agenda to schedule a meeting with its national member associations. The get-together aims at sharing important project and policy updates with members ahead of the associations General Assembly. During the 23rd Congress, the EAHP gathered over two-thirds of its national member associations in Gothenburg to share the latest news on the Statement Implementation project and the Common Training Framework (CTF) for a hospital pharmacy specialisation as well as on policy issues relevant to the hospital pharmacy profession.

EAHP Vice President Aida Batista kicked-off the meeting with a sneak-peak on the European Statements of Hospital Pharmacy Survey Results for 2017. In her presentation, she highlighted that the awareness and the importance given to the European Statements is beginning to increase significantly. Moreover, she pointed out that hospital pharmacists continue to have difficulty participating in and publishing practice research, since 75% of the respondents indicated that they have produced less than 2 external presentations, papers or posters in the past year. She concluded her presentation with an outlook on the 2018 survey activity.

Statement Implementation Project Director Tony West, updated EAHP national member associations on the milestones that the project had achieved in the past 9 months. He addressed the activities of the national implementation ambassadors which are doing a tremendous job in raising awareness about the Statements in their individual countries. Moreover, he provided the group with impressions on the launch of the EAHP selfassessment tool (SAT) and the Statement Implementation Learning Collaborative Centres (SILCC) programme.

Representatives of EAHP’s national member associations were encouraged to drop-by the EAHP booth to learn more

about SILCC and SAT from the Statement Implementation team.

meeting to contribute to the discussion and to answer questions of the hospital pharmacy community.

President Joan Peppard elaborated on the milestones that the CTF project reached in November 2017 with the finalisation of the competency framework and in January 2018 through the publication of the Labour Mobility Survey results. She also mentioned the outreach activity that is currently being carried out by the Communication Working Group which involves the updating of the CTF website. Last but not least she gave a brief outlook on the information that will be presented at the General Assembly in June which will include the strategic proposal of Working Group 4.

The meeting was opened by a presentation of EAHP on the current status of FMD implementation in the hospital sector.

It touched upon EAHP’s membership in the European Medicines Verification Organisation (EMVO), the hospital platform set up together with the European Hospital and Healthcare Federation (HOPE) and EMVO as well as on EAHP’s awareness raising efforts. Moreover, the concerns of hospital pharmacist including but not limited to the lack of involvement of hospital pharmacists in activities of National Medicines Verification Organisations (NMVOs), the lack of engagement by national competent authorities as well as the reluctance of EMVO and industry to use aggregated coding were highlighted. The last part of the presentation touched upon a business impact analysis carried out by the Netherlands which showed that hospital pharmacies will have to cover costs much higher than 750 Euros for the implementation of FMD.

During the policy update, Nenad Miljkovic shared information on the recently launched 2018 Medicines Shortage survey as well as on COST Action CA15105 European Medicines Shortages Research Network addressing supply problems to patients (Medicines Shortages), while Steffen Amann elaborated on the initiatives that were undertaking to combat the rising threat of antimicrobial resistance. The update by Rob Moss on FMD sparked a lively discussion on the implementation of the scanning and verification obligations. The meeting was concluded by a brief presentation of Joan Peppard on the new medical devices legislation and the current consultations on European level.

EAHP members meeting on FMD with the European Commission The Delegated Regulation laying down detailed rules for the safety features appearing on the packaging of medicinal products for human use, is currently one of the legal instruments that is keeping hospital pharmacies all over Europe busy. After 9th February 2019, hospital pharmacists are under legal obligations to conduct verification scans of each package of medicine received by the hospital. With only 10 months left before FMD will become a reality in hospital pharmacies throughout Europe, EAHP decided to host a discussion for its members to provide them with the opportunity to share best practices. In addition, Dr Patrizia Tosetti – Policy Officer at the Commission Directorate for Health and Food Safety (DG Sante) was invited to the

Each EAHP member representative was provided with the opportunity to share information on the current status of FMD implementation. Measures taken included but were not limited to awareness campaigns, looking for software solutions with hospital IT providers, conducting workshops and hosting discussions. A number of countries highlighted that pilot projects are planned in summer and/or fall 2018 to test the National Medicines Verification Systems (NMVS).

Speaking after the meeting Rob Moss Director for Professional Development and EAHP Board lead on FMD voiced his positive feeling about the great initiatives that have been taken by EAHP’s national member associations to move the implementation of FMD forward in their respective countries. He highlighted that not just he but also European Commission representative Patrizia Tosetti was impressed by the actions taken at National level. Much still remains to be done but the steps taken by EAHP’s national member associations clearly showed that the hospital pharmacy sector is driving implementation forward.

Stephanie Kohl – EAHP Policy Officer

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KEYNOTE 3 REVIEW

Marketing the hospital pharmacy profession

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atherine Picton, as experienced healthcare and policy consultant at the Royal Pharmaceutical Society, (RPS) tried to bring hospital pharmacists in closer contact with the marketing of their profession. To better illustrate her points, she started out with explaining how RPS supports the pharmacy profession. To this end she referred to three different publications, the Professional Standards for Hospital Pharmacy Services, the Medicines Optimisation Good Practice Guidance and the Competency Framework for all Prescribers.

In relation to the Professional Standards for Hospital Pharmacy Services, Ms Picton highlighted their practical usefulness for the pharmacy team in recognising, developing and delivering the best possible outcomes for patients. The 2017 update of the Standards allowed for the inclusions of new dimensions – namely digital technology and informatics.

These standards should be promoted to patients, hospital directors, physicians and other personnel working in the hospital setting.

After briefly introducing the Medicines Optimisation Good Practice Guidance and the Competency Framework for all Prescribers, Ms Picton moved on to the next part of the presentation centring around three themes for marketing the profession - understanding your audience, communication and leadership.

Understanding your audience and their needs is very important. To illustrate this, Ms Picton contextualised the Five Year Forward View of the National Health Service (NHS). To meet the needs of future patients in a sustainable way three gaps need to be closed between 2014 and 2019. These gaps relate to the health and wellbeing, the care and quality as well as to funding and efficiency. One of the consequences is the introduction of a seven-day clinical pharmacy service in hospitals. Considerations to lower drug cost are becoming important as well. Another example of the concept of ‘understanding your audience’ was the introduction of the medicines value programme which aims at helping patients get the

best results from their medicines, while achieving the best value for the health system.

Communication as a way to make pharmacy ser vices understood outside the pharmacy was explored as the second main theme.

New models of care were introduced in 2014 by the Communication Mariona Ribó on the future models of care delivered through pharmacy. Making the shift from acute to integrated care is important to the NHS. Pharmacists have been identified as key players in this process.

Ms Picton further pointed out that there is insufficient public awareness of the pharmacy services. There are more roles for hospital pharmacists in the future as highlighted by pharmacists working in the area of urgent & emergency care.

The last part of her presentation focused on the third theme – leadership. Ms Picton urged hospital pharmacists to develop their leadership skills. Initiatives such as the Chief Pharmacist Development Programme and the hospital advisory group of RPS help chief pharmacists to achieve this goal.

Medicine Shortages

Dr. Berry van Schaik

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24 th EAHP Congress