RESUMEN
Objectives: This study aimed to assess the budget and organizational impact of progressively replacing the intraoperative cell salvage centrifugation-based systems currently installed in French hospitals with the same™ system, a new autotransfusion medical device.Methods: An Organizational and Budget Impact Model (OBIM) was developed based on two methodological guidelines issued by the French Health Authority (Haute Autorité de Santé, HAS). The OBIM was also developed based on a pragmatic literature review, hospital data and hospital pharmacists' expertise.Results: Considering an average hospital cohort of 600 cardio-thoracic surgery patients, with 57% experiencing mild hemorrhages, 23% moderate hemorrhages, and 20% massive hemorrhages, and a same™ market share of 33% in Year 1, the implementation of same™ resulted in significant savings. With an average allogeneic transfusion of 4.19 packed red blood cells (RBC) and 0.62 platelet concentrate per patient based on National Hemovigilance Report of the ANSM (French National Agency for the Safety of Medicines and Health Products) and when using same™ system a reduction of 45% of RBC transfusion associated with a reduction of 60% and 90% of platelet use for moderate and massive hemorrhages respectively, the first year annual saving amounted to 44,601 and the cumulated saving over 5 years to 535,206.Discussion: This model structure was developed based on overall hospitals' needs and acknowledged guidelines, with inputs based on French literatures and hospital data, so findings were specifics to a context. Among the inputs, the number of annual same™ procedure is not based on device capability but rather on hospital capability with the number of operating rooms used for cardio-thoracic surgery equipped with the device.Conclusions: The results of this OBIM demonstrated the economic and organizational benefits of same™ for hospitals. This benefit results mainly of a reduction in the use of allogeneic blood products (RBCs, platelets).
RESUMEN
BACKGROUND: In French hospitals, the supply and management of drugs are missions of pharmacists. The aim of this study is to assess the use of efficacy and economics opinions of the Haute Autorite de santé (HAS) in hospital referencing of drugs in France in 2017. METHODS: A questionnaire for hospital pharmacists was developed to establish their knowledge and their uses of Transparency Commission and Economic and Public Health Evaluation Committee opinions. This survey was distributed by the ADIPH association in July 2017. This questionnaire included 35 questions. RESULTS: Despite the health professional are more and more interesting by economics analysis, only 30 % of hospitals pharmacists of this panel declared to use HAS economic opinions (versus 80% for Transparency Commission opinions). Among these pharmacists, 86% used this report in the hospital referencing of drugs. CONCLUSION: Through this analysis, some prospects for improvement can be seen in the health professional formation, cost-effectiveness report publication and the use of cost-effectiveness analysis. This study is an overview of the use of opinions provided by the HAS. This thesis established a basis to reflection on the use of economics reports and models in the hospital decisions.