OP0300 Reducing avoidable biologic drug wastage through collaboration between patients and care providers: the leeds spondyloarthritis service experience
Authors: A. Barr, D. Pickles, N. Fadl, J. Dou, C. Vandevelde, S. Dubash, J.E. Freeston, H. Marzo-Ortega
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> The Leeds rheumatology department manages a cohort of approximately 4,000 patients with inflammatory arthritis receiving biologic therapies with an estimated annual cost of 15,000,000. Of these, approximately 1,000 have axial Spondyloarthritis or Psoriatic arthritis (SpA). Biologic drug wastage with self-injectable drugs can occur when patients have no further use for their existing stockpile of drug (typically occurring when receiving further stock around the time of stopping, pausing or switching drugs). Wastage is recorded by home-delivery companies on receiving returned unusable stock. With intravenous drugs, wastage occurs when patients don9t attend infusions. Reducing risk of self-injectable wastage has been achieved (1) butreducing self-injectable and intravenous biologic wastage has not. <h3>Objectives</h3> To establish whether a patient information letter couldbe used toreduce measured biologic drug wastage. <h3>Methods</h3> All SpA patients receiving biologic therapies (infusion or self-injectable) were identified by prescription records. Wastage (recorded by the infusions ward &amp; home-delivery companies) was reviewed from January 2016 until May 2017. A patient information leaflet (PIL) was developedand sent simultaneously to all patients advisinghow to minimise wastage (ie: call the infusions ward or delivery companies early when unable to attend andpausing, stopping or switching biologics respectively). The same wastage was measuredfor4 months afterwards. <h3>Results</h3> In the 16 months prior to the PIL intervention an estimated 81,000 of wastage was measured. Of this, 80% was due to infusion ward wastage (n=45 infliximab infusions) and 20% was due to self-injectable biologics. Following the PIL intervention, no wastage was measured either on the infusion ward or for self-injectable biologics. This resulted in a projected annual saving of 61,000 (80% of which was related to avoidable infliximab wastage). During the observation period the total number of patients taking biologics did not change significantly. No adverse events have been associated with this PIL. Limitations include; a standardised infliximab dose banding was introduced during the final month which may havereduced wastage; Etanercept/etanercept biosimilar data are incomplete as the project is ongoing and aretherefore excluded from the analysis. <h3>Conclusions</h3> This is the first intervention demonstrating areduction in measured biologic drug wastage. It represents a simple, reproducible and sustainable intervention through a collaborative effort between patients and health care providers and offers potential significant savings in a time of austerity. <h3>Reference</h3> [1] Whiteman, et al. <i>Rheumatology</i>April 2016;55(suppl 1):i119. <h3>Acknowledgements</h3> UCB Pharma UK for sponsoring this project Sheona Gillies – Information Analyst, LTHT facilitating mailshots <h3>Disclosure of Interest</h3> None declared