AIFA anti-tumor drugs platform break: a good clinical management

Abstract

Background: When the AIFA (Agenzia Italiana Del Farmaco) online drugs prescription program was broken in December 2013, every Italian oncology ward didn't have the means to record the new prescriptions of monitored anti-tumor drugs on the program itself, as required by the national guidelines. This system damage also prevented the access to the old data of patients still in treatment. At the Oncology Day Hospital of Guastalla, after this event a new inner database was created in order to record all the new prescriptions. For patients who began anti-tumor treatments before the break, old data prescriptions were needed to continue the chemotherapy. These were taken from the paper medical records and inserted in the database. AIFA did not give any guideline or direction to follow after the program break. April 2014, AIFA created a completely new platform for recording drug prescriptions. From that moment, every Oncology Unit had to insert in the new program both all the drugs prescribed during previous 16 months and the new prescriptions not later than December 2014. Materials and methods: In our Oncology DayHospitalin Guastalla, a target working group was created in order to perform this job. The group was composed by an oncologist and a pharmacist, both supervised by their respective chiefs. They met twice a week to record all the pending data, working from 8.30 to 14. The work was very hard because of the inadequate AIFA guidelines and the delayed answers to team queries. Both oncology and pharmaceutical Department suffered from the absence of a single professional referent . For each patient and for each drug, the working group had to collect the natural history of the disease, the time of progression and the number of chemotherapy cycles. This analysis was necessary for every drug in order to obtain the pay back of the costs of the treatment itself. In fact, there are different types of pay back in relation to the cancer diagnosis, the kind of drug and the results of the treatment. Results: The working team succeeded in completing the AIFA new drug prescription program before the deadline. The local Health Trust received the expected pay back for the prescribed treatments. Conclusions: This experience is an example of an integrative work between professionals from different areas. Successful results could be obtained thanks to the good management skills of the professionals involved, despite the lack of guidelines and support from AIFA.