Registry of patients and treatments of hospital medicines in Catalonia (Spain): 10 years of clinical data

Registre de pacients; Medicaments hospitalaris; Dades clíniquesPatient registration; Hospital medicines; Clinical dataRegistro de pacientes; Medicamentos hospitalarios; Datos clínicosDurante el año 2011 se diseñó el actual Registro de Pacientes y Tratamientos MHDA (RPT-MHDA), un único registro específico y centralizado para todos los hospitales del SISCAT, con el objetivo de recoger, de forma sistemática, información sobre utilización, efectividad y seguridad de los MHDA en condiciones de práctica clínica habitual, así como el grado de adherencia a los criterios definidos por el PHF

Implementing reflective multicriteria decision analysis (MCDA) to assess orphan drugs value in the Catalan Health Service (CatSalut)

Catalan healthcare; Decision-making; Multi-criteria decision analysis; Orphan drugsSanitat catalana; Presa de decisions; Anàlisi de decisions multicriteri; Medicaments orfesSanidad catalana; Toma de decisiones; Análisis de decisiones multicriteria; Medicamentos huérfanosBACKGROUND: Orphan medicines show some characteristics that hinder the evaluation of their clinical added value. The often low level of evidence available for orphan drugs, together with a high budget impact and an incremental cost-effectiveness ratio many times higher than drugs used for non-orphan diseases, represent challenges in their appraisal and effective access to clinical use. In order to explore how to handle these hurdles, the Catalan Health Service (CatSalut) began an initiative on a multidimensional assessment of drugs value during the appraisal process. Reflective multicriteria decision analysis (MCDA) using analytical methods was chosen, since it may help to standardise and contextualize all the relevant data related with the drug that could contribute to a decision. The aim of the study was to determine whether the implementation of reflective MCDA methodology could support the decision-making process about orphan medicines in the context of CatSalut. METHODS: The assessment and decision-making process for orphan drugs in the Programa d'Harmonització Farmacoterapeutica (PHF) of CatSalut was prioritized to test the implementation of the reflective MCDA both a qualitative and quantitatively. A staged approach was used with the following main steps: selection and structuration of quantitative criteria (Core Model) and qualitative criteria (Contextual Tool), framework scoring and assessment of three orphan drug case studies. This proof-of-concept would grant a continued refinement of the methodology and, if and when validated, its potential integration to other therapeutic areas of the PHF. RESULTS: The final framework was composed by 10 quantitative criteria (Core Model) and 4 qualitative criteria (Contextual Tool) according to the PHF goals being the most important criteria "disease severity", "unmet need", "comparative effectiveness" and "comparative safety /tolerability". The matrix developed for the case studies served as a guide for the selection of the essential information that the decision-makers were expected to include in a framework. The reflective discussion was considered the most relevant phase of the approach to support inputs for health decision-making processes reflecting both drug value and place in therapy. CONCLUSIONS: The study showed that reflective MCDA methodology could be implemented to complement the decision-making process in CatSalut, as an aid to determine the clinical added value for orphan medicines. MCDA provided transparency and a structured discussion during the committee meetings, thus increasing transparency and predictability of the relevant items supporting the agreements adopted on orphan drugs access

El Programa d’Innovació i Suport en l’Àmbit del Medicament de l’AIAQS

Innovació en salut; Prestació farmacèutica; Avaluació de medicamentsInnovación en salud; Prestación farmacéutica; Evaluación de medicamentosHealth innovation; Pharmaceutical Services; Drug EvaluationAquest nou programa de caràcter transversal i que es nodreix dels àmbits de coneixements en què l’AIAQS té experiència, persegueix l’objectiu de contribuir a augmentar la qualitat i garantir la seguretat de l’atenció sanitària que reben els ciutadans catalans, mitjançant actuacions específicament adreçades a millorar l’ús dels medicaments. El programa pretén facilitar la presa de decisions del CatSalut en matèria de prestació farmacèutica, proporcionant i dissenyant nous elements de suport adreçats a millorar les decisions en matèria de finançament, compra de serveis i avaluació de resultats (econòmics, clínics i de qualitat de vida) lligats a la terapèutica farmacològica.Este nuevo programa de carácter transversal y que se nutre de los ámbitos de conocimientos en que la AIAQS tiene experiencia, persigue el objetivo de contribuir a aumentar la calidad y garantizar la seguridad de la atención sanitaria que reciben los ciudadanos catalanes, mediante actuaciones específicamente dirigidas a mejorar el uso de los medicamentos. El programa pretende facilitar la toma de decisiones del CatSalut en materia de prestación farmacéutica, proporcionando y diseñando nuevos elementos de apoyo dirigidos a mejorar las decisiones en materia de financiación, compra de servicios y evaluación de resultados (económicos, clínicos y de calidad de vida) ligados a la terapéutica farmacológica.This new transversal program, which is based on the areas of knowledge in which AIAQS has experience, pursues the objective of contributing to increase the quality and guarantee the health care received by Catalan citizens, by means of specific actions aimed at improving the use of medications. The program aims to facilitate the decision making of CatSalut in the field of pharmaceutical services, providing and designing new support elements aimed at improving decisions regarding financing, purchase of services and evaluation of results (economic, clinical and quality of life) linked to pharmacological therapeutics

Flexural strength of high-performance soil-cement: a new, alternative, sustainable construction material

Soil-cement is a building material that is considered low-cost and has a low environmental impact. Despite its benefits, performance optimisation studies are scarce compared to other materials such as concrete. The possibility of obtaining soil-cement with improved characteristics, such as flexural strength, would enable the increased use of this product in new applications in construction. The aim of this study is to produce high-performance soil-cement (HPSC) specimens and to evaluate and compare this new material with high-performance concrete (HPC) in terms of flexural strength. A total of 12 specimens were produced with a mixture of 23.5% (by mass) of cement with the application of 10 MPa of pressure for its compaction. The results show that, at 28 days, the specimens reached an average strength of 6.73 MPa and, at 240 days, 12.34 MPa. This means that the HPSC reached a flexural strength resistance equivalent to HPC without the need for mined materials, such as sand and gravel, or the additives adopted in some doses of HPC, such as superplasticisers. Therefore, when using local soil, HPSC can be considered an environmentally preferable alternative to HPC for many construction applications where flexural strength is a requirement.Peer ReviewedPostprint (published version

Registry of patients and treatments of hospital medicines in Catalonia (Spain): 10 years of clinical data

Registre de pacients; Medicaments hospitalaris; Dades clíniquesPatient registration; Hospital medicines; Clinical dataRegistro de pacientes; Medicamentos hospitalarios; Datos clínicosDurante el año 2011 se diseñó el actual Registro de Pacientes y Tratamientos MHDA (RPT-MHDA), un único registro específico y centralizado para todos los hospitales del SISCAT, con el objetivo de recoger, de forma sistemática, información sobre utilización, efectividad y seguridad de los MHDA en condiciones de práctica clínica habitual, así como el grado de adherencia a los criterios definidos por el PHF

El Programa d’Innovació i Suport en l’Àmbit del Medicament de l’AIAQS

Innovació en salut; Prestació farmacèutica; Avaluació de medicamentsInnovación en salud; Prestación farmacéutica; Evaluación de medicamentosHealth innovation; Pharmaceutical Services; Drug EvaluationAquest nou programa de caràcter transversal i que es nodreix dels àmbits de coneixements en què l’AIAQS té experiència, persegueix l’objectiu de contribuir a augmentar la qualitat i garantir la seguretat de l’atenció sanitària que reben els ciutadans catalans, mitjançant actuacions específicament adreçades a millorar l’ús dels medicaments. El programa pretén facilitar la presa de decisions del CatSalut en matèria de prestació farmacèutica, proporcionant i dissenyant nous elements de suport adreçats a millorar les decisions en matèria de finançament, compra de serveis i avaluació de resultats (econòmics, clínics i de qualitat de vida) lligats a la terapèutica farmacològica.Este nuevo programa de carácter transversal y que se nutre de los ámbitos de conocimientos en que la AIAQS tiene experiencia, persigue el objetivo de contribuir a aumentar la calidad y garantizar la seguridad de la atención sanitaria que reciben los ciudadanos catalanes, mediante actuaciones específicamente dirigidas a mejorar el uso de los medicamentos. El programa pretende facilitar la toma de decisiones del CatSalut en materia de prestación farmacéutica, proporcionando y diseñando nuevos elementos de apoyo dirigidos a mejorar las decisiones en materia de financiación, compra de servicios y evaluación de resultados (económicos, clínicos y de calidad de vida) ligados a la terapéutica farmacológica.This new transversal program, which is based on the areas of knowledge in which AIAQS has experience, pursues the objective of contributing to increase the quality and guarantee the health care received by Catalan citizens, by means of specific actions aimed at improving the use of medications. The program aims to facilitate the decision making of CatSalut in the field of pharmaceutical services, providing and designing new support elements aimed at improving decisions regarding financing, purchase of services and evaluation of results (economic, clinical and quality of life) linked to pharmacological therapeutics

Implementing reflective multicriteria decision analysis (MCDA) to assess orphan drugs value in the Catalan Health Service (CatSalut)

Catalan healthcare; Decision-making; Multi-criteria decision analysis; Orphan drugsSanitat catalana; Presa de decisions; Anàlisi de decisions multicriteri; Medicaments orfesSanidad catalana; Toma de decisiones; Análisis de decisiones multicriteria; Medicamentos huérfanosBACKGROUND: Orphan medicines show some characteristics that hinder the evaluation of their clinical added value. The often low level of evidence available for orphan drugs, together with a high budget impact and an incremental cost-effectiveness ratio many times higher than drugs used for non-orphan diseases, represent challenges in their appraisal and effective access to clinical use. In order to explore how to handle these hurdles, the Catalan Health Service (CatSalut) began an initiative on a multidimensional assessment of drugs value during the appraisal process. Reflective multicriteria decision analysis (MCDA) using analytical methods was chosen, since it may help to standardise and contextualize all the relevant data related with the drug that could contribute to a decision. The aim of the study was to determine whether the implementation of reflective MCDA methodology could support the decision-making process about orphan medicines in the context of CatSalut. METHODS: The assessment and decision-making process for orphan drugs in the Programa d'Harmonització Farmacoterapeutica (PHF) of CatSalut was prioritized to test the implementation of the reflective MCDA both a qualitative and quantitatively. A staged approach was used with the following main steps: selection and structuration of quantitative criteria (Core Model) and qualitative criteria (Contextual Tool), framework scoring and assessment of three orphan drug case studies. This proof-of-concept would grant a continued refinement of the methodology and, if and when validated, its potential integration to other therapeutic areas of the PHF. RESULTS: The final framework was composed by 10 quantitative criteria (Core Model) and 4 qualitative criteria (Contextual Tool) according to the PHF goals being the most important criteria "disease severity", "unmet need", "comparative effectiveness" and "comparative safety /tolerability". The matrix developed for the case studies served as a guide for the selection of the essential information that the decision-makers were expected to include in a framework. The reflective discussion was considered the most relevant phase of the approach to support inputs for health decision-making processes reflecting both drug value and place in therapy. CONCLUSIONS: The study showed that reflective MCDA methodology could be implemented to complement the decision-making process in CatSalut, as an aid to determine the clinical added value for orphan medicines. MCDA provided transparency and a structured discussion during the committee meetings, thus increasing transparency and predictability of the relevant items supporting the agreements adopted on orphan drugs access