OBJECTIVES: Hospital Pharmacy Services have had to adapt their outpatient consultation services to introduce telepharmacy procedures because of the SARS-CoV-2 pandemic. New methods of drug dispensation are explored to minimize risk of infection and optimize patient access to medicines. The aim of this study is to evaluate, in economic terms, the consequences of replacing conventional drug dispensation in outpatient pharmacy clinics with new methods using the example of biologic drugs to treat moderate-to-severe plaque psoriasis.

METHODS: Different scenarios of drug dispensation were estimated for psoriasis in the Spanish context, such as dispensing at hospital, at primary care, at community pharmacy or home delivery service. All self-injectable drugs for the treatment of moderate-to-severe plaque psoriasis were considered, including both interleukin (IL) inhibitors (tildrakizumab, guselkumab, risankizumab, secukinumab, ixekizumab, brodalumab and ustekinumab) and Tumour Necrosis Factor alpha (TNF-α) inhibitors (adalimumab, etanercept and certolizumab). The analysis adopted the perspective of Spanish National Healthcare System (NHS) and direct costs were obtained from local literature and national databases updated to €2020.

RESULTS: In the current scenario, considering frequency of dispensation according to each biologic posology and hospital as a site of dispensation, the annual cost of drug dispensation per patient ranged from €194.9 (tildrakizumab) to €2,171.6 (etanercept). In the most costly scenario (dispensation based on each biologic posology with home delivery service), dispensation costs of the drugs ranged from €227.0 to €2,364.0 per patient/year (tildrakizumab vs. etanercept), while in the least costly scenario (dispensing at primary care or at community pharmacy every 2 months), those costs ranged from €187.4 to €281.0 per patient/year.

CONCLUSIONS: Adapting the model of drug dispensation to minimize risk of infections would have economic implications for the NHS. These outcomes would meaningfully vary depending on the site and frequency of dispensation, being the latter dependant on the posology of the biologic treatment.