4CPS-234 Results of the implementation of an efficiency-based age-related macular degeneration treatment protocol

<h3>Background and Importance</h3> Three of the 10 drugs with the highest consumption in our study centres correspond to therapies for age-related macular degeneration (ARMD). Given the high cost of these drugs, the increase in the diagnosis rate of this pathology and the ageing of the population, the hospital pharmacist plays a very important role in the creation of protocols that result in budgetary sustainability. <h3>Aim and Objectives</h3> Analyse the degree of compliance with the ARMD protocol established in two study hospitals and the economic impact of its establishment. <h3>Material and Methods</h3> All drug prescriptions for ARMD (faricimab, aflibercept and ranibizumab) were analysed retrospectively from 1 January 2023 to 30 September 2024 and the comparative study was carried out between periods with and without ARMD protocol (1 January 2023 to 5 May 2024 vs 6 May to 30 September 2024). The protocol established the front-line use of ranibizumab, followed by faricimab and last-line aflibercept for efficiency criteria. The prices of each preparation were calculated excluding indirect costs (syringes, needles and labour). <h3>Results</h3> During the period without ARMD protocol (1 January 2023 to 5 May 2024), 140 treatments were initiated (110 (78.6) with ranibizumab and 30 (21.4%) with aflibercept) and after the implementation of the protocol (6 May to 30 September 2024), 75 patients were started (52 (69.3) with ranibizumab, 13 (17.3%) with aflibercept and 10 with faricimab (13.3%)). Regarding treatment changes after implementation, there were 89 line changes: 29 changed from aflibercept to faricimab (seven of which had not gone through ranibizumab), 27 changed from ranibizumab to faricimab and 30 from ranibizumab to aflibercept; and only three from faricimab to aflibercept (prior to ranibizumab). The overall degree of protocol compliance was 41.6% and the opportunity cost, or in other words, the cost of not choosing the best option, has been €43,252 since the implementation of the protocol. <h3>Conclusion and Relevance</h3> Given the high economic impact of the drugs used in ARMD, the implementation and monitoring of compliance with protocols based on efficiency seems important for sustainability. In this specific case, there is significant room for improvement in the use of drugs for ARMD. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest