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Pharmacist Integration into the Hemophilia Treatment Centre: A Canadian Pilot Project to Optimize Treatment and Improve Cost-savings
  • +8
  • Jameason Cameron,
  • Nisha Varughese,
  • Sylvain Grenier,
  • Damien Roux,
  • Robert Klaassen,
  • Alex Wong,
  • Caitlin Jones,
  • Sarah Jennings,
  • Utsav Patel,
  • Simmi Sidhu,
  • Regis Vaillancourt
Jameason Cameron
Children's Hospital of Eastern Ontario Research Institute

Corresponding Author:[email protected]

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Nisha Varughese
Children's Hospital of Eastern Ontario Research Institute
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Sylvain Grenier
Canadian Blood Services
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Damien Roux
Children's Hospital of Eastern Ontario Research Institute
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Robert Klaassen
Children's Hospital of Eastern Ontario Research Institute
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Alex Wong
Children's Hospital of Eastern Ontario Research Institute
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Caitlin Jones
Canadian Blood Services
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Sarah Jennings
Canadian Blood Services
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Utsav Patel
Canadian Blood Services
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Simmi Sidhu
Canadian Blood Services
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Regis Vaillancourt
Children's Hospital of Eastern Ontario Research Institute
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Abstract

Coagulation factors used in prophylactic treatment of patients with clotting disorders are associated with significant costs to health care systems. These products have complex pharmacokinetic profiles subject to large inter-individual variation making their efficient use challenging. Prior to this project, pharmacists were not involved as part of the Hemophilia care teams across Canada. The purpose of this pilot project was to determine whether employment of a pharmacist with expertise and a focus on plasma protein and related products including hemophilia treatments, would be an effective strategy to reduce costs associated with clotting factor prophylaxis regimens and identify the pharmacist’s activities associated with this new role. A cost-minimization analysis was conducted to compare the addition of a pharmacist to the care team of the Hemophilia Treatment Centre (HTC) at a pediatric hospital serving 500,000 children and youth. The analysis was performed from the perspective of the formulary manager, Canadian Blood Services, over a 1-year period including 9 months of interventions. The pharmacist performed 18 therapeutic optimizations on 14 patients with moderate to severe hemophilia A or B, and 1 von Willebrand patient, aged 3 to 18 years old. As a result of the pharmacist’s intervention, clotting factor treatment costs extrapolated over one year were reduced by 20.5% for these patients. This represents a net savings of $225K CAD/year, or $12.5K CAD/optimization/year. The addition of a pharmacist to the HTC to manage recombinant and plasma-derived coagulation factors can optimise the treatment plan and significantly reduce the costs of managing patients with hemophilia.
21 Mar 2023Submitted to Pediatric Blood & Cancer
21 Mar 2023Submission Checks Completed
21 Mar 2023Assigned to Editor
21 Mar 2023Review(s) Completed, Editorial Evaluation Pending
29 Mar 2023Reviewer(s) Assigned
28 Apr 2023Editorial Decision: Revise Major