5PSQ-020 Multidisciplinary protocol for the use of medicines: let’s talk about intravitreal therapy

<h3>Background and Importance</h3> Intravitreal therapy (IVT) arises from the need to increase drug dosage at ocular level. It is used in the treatment of pathologies like age-related-macular-degeneration or diabetic macular oedema. <h3>Aim and Objectives</h3> To describe the protocol for use of IVT, guaranteeing its safety-effectiveness. To evaluate economic impact. To standardise clinical practice. To improve efficiency of these medications, which have high-economic-population impact. <h3>Material and Methods</h3> Multidisciplinary study Pharmacy-Ophthalmology in a second-level hospital; a working group established in September 2023. <h3>Bibliographic search: </h3> guidelines-protocols from Spanish Society Retina Vitreous (SERV) and Spanish Society Hospital Pharmacy; technical sheets from Spanish Agency Medicines and Therapeutic Positioning Reports from national/regional Health-Service. Farmatools-Montesinos were used to obtain economic data (January 2021-December 2023). Periodic meetings were held, developing the protocol: Indications-criteria for IVT commercialised included in our Pharmacotherapeutic Guide (PG). Development the prescription/administration; validation medical order/preparation/dispensing/registration. Traceability. Economic impact. <h3>Results</h3> PG includes six commercialised IVT: aflibercept, ranibizumab, dexamethasone, broluzicimab and fluocinolone (that do not require manipulation); faricimab (vial can be fractionated). This protocol specifies indications for each one. Development of the procedure: prescription is made individually using ‘Order for Dispensing Medicines for Hospital-Use’ (MambrinoXXI). Administration is done in ophthalmology room according to ‘single act’ model of SERV ITV Consensus Document. From the pharmacy, a consensual supply stock (aflibercept-dexamethasone-ranibizumab) is dispensed daily to ‘single act’ room, preparing different batches of each medicine for patients with bilateral involvement. Extra dispensations can be made. The rest are dispensed on-demand after individualised prescription. All medical orders are validated by pharmacists. To ensure traceability, the name-batch-expiration date of the medication administered to each patient are identified and registered. <h3>Economic impact and healthcare burden: </h3> 2021/2022/2023 the cost was 383,681/445,113/520,174 €; associated with 402/493/518 patients, a figure that is increasing. <h3>Conclusion and Relevance</h3> Despite the exponential increase in the cost of IVT, mainly due to an increase in number of patients; in redosing faricimab, a reduction in IVT costs is expected. Development of multidisciplinary protocols allows for improved health outcomes through the provision of individualised pharmacotherapeutic treatment, allowing each patient to receive IVT they need at a sustainable cost. The approach to IVT is a challenge that is implemented with ophthalmology-pharmacy alliances, which must be carried out. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest