Only 11% of public hospitals evaluate the use of medicines on patients' quality of life in the medium and long term, reveals a study released today by the Portuguese Association of Hospital Administrators (APAH).
The National Index of Access to Hospital Medicines 2023, which is presented today in Lisbon at the Medicines Forum, reveals that this value has dropped compared to 2020, the year in which 30% of hospitals in the National Health Service (SNS) carried out an effectiveness assessment and drug safety based on real-life data.
For the president of APAH, this is the “most worrying” data from the study: «We spend many millions of euros on purchasing medicines in hospitals and we are not evaluating the health value that these medicines add».
As the results are not evaluated, it is not possible to use this information to make better negotiations with the industry, he said, highlighting that in health systems in many countries “risk sharing agreements are perfectly disseminated and support negotiations between suppliers and hospitals”.
The person responsible explained that, if the clinical result of the medicine in the lives of patients is not verified, «the price can and should be readjusted».
«This is a fundamental aspect that allows us to establish agreements, share risk with the industry, but also understand which medicines have better results for patients and, in this sense, encourage what is true innovation, the medicines that actually they add value to health and make a difference in the day-to-day lives of our patients», he argued.
The study also reveals that, after the introduction of a new therapy, 61% of institutions do not have a mechanism for reassessing its results.
According to Xavier Barreto, spending on hospital medicine increased by 12% in 2022 and this year it is growing at the same level, above 10%.
In his opinion, “it is nonsense” to invest “so many resources from the public treasury in technology that is not then properly evaluated”, arguing that this is a matter that should concern everyone and constitute “a priority for the Government”.
As reasons for there being fewer institutions carrying out this assessment, he pointed out the overload that hospitals currently have and, often, even the lack of training in their structures.
On the other hand, he said, "many pharmaceutical services have human resources, particularly qualified human resources [pharmacists], below what they should have" and, often, purchasing services also lack qualified professionals to carry out value-based purchasing processes. .
«And therefore, in truth, hospital structures are not capable, they do not have this focus, this priority of measuring this dimension, the value in health, which is added by medicines and then using this information, namely, in terms of public procurement », he concluded.
The study has scientific support from the Faculty of Pharmacy of the University of Lisbon and is supported by the Order of Pharmacists and the Portuguese Association of Hospital Pharmacists.
The main objectives are “to determine the level of access to hospital medicine and analyze the management models, mechanisms for creating evidence and measuring results associated with it, and identifying existing barriers and/or problems associated with equity of access, management and dispensing of medication in NHS hospital institutions”.
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