{
  "abstract": "Background and Importance The Healthcare Management of our Centre, in 2024, established a technical working group aimed at monitoring the appropriateness of therapeutic decisions in oncology and ensuring the efficient use of available economic resources.The pharmacy department in collaboration with the oncology Unit defined as inappropriate those treatments administered to patients who died by the disease within 30 days after the initiation of immunotherapy. Accordingly, the following indicator was identified: the number of patients who died within 30 days of starting therapy divided by the total number of patients initiating immunotherapy.Aim and Objectives The aim of this study was to assess therapeutic appropriateness and decision making through the selected indicator and to quantify the economic impact of treatments considered inappropriate, as they proved to be clinically ineffective.Material and Methods Data from electronic medical records were analysed to identify naïve patients who received immunotherapy during 2023, and these were compared with naïve patients treated in 2024. An Excel file was generated reporting, for each active substance, the patients who initiated immunotherapy during 2023 and 2024, the number of administrations received and the date of death. Subsequently, using our inventory management system, the treatment costs for patients who died within 30 days from the initiation of therapy were calculated.Results In 2023 and 2024 we used seven immunotherapeutic drugs: pembrolizumab (230 patients), durvalumab (45 patients), atezolizumab (45 patients), cemiplimab (22 patients), dostarlimab (5 patients), avelumab (15 patients), nivolumab (95 patients), ipilimumab (49 patients), tremelimumab (6 patients). In 2023 and 2024, 214 and 246 patients, respectively, initiated immunotherapy. Of these, 45 (21.03%) and 21 (8,5%) patients, respectively, died within 30 days of treatment initiation. The cost for these patients in 2023 and 2024, respectively, was 5.41% and 2.5% of the cost for all naïve patients.Conclusion and Relevance Immunotherapy has revolutionised the treatment of cancer patients; however, to enable as many patients as possible to benefit from the available therapies, it is essential that prescribing appropriateness criteria are carefully observed. We have to find indicators to evaluate ineffectiveness treatment. In this study, monitoring the selected indicator led to a reduction in inappropriate treatments and a more efficient use of available economic resources.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Ast Macerata, Hospital Pharmacy, Macerata, Italy"
      ],
      "name": "S Giorgetti"
    },
    {
      "affiliations": [
        "University of Camerino, School of Hospital Pharmacy, Camerino, Italy"
      ],
      "name": "N Mandolesi"
    },
    {
      "affiliations": [
        "Ast Macerata, Hospital Pharmacy, Macerata, Italy"
      ],
      "name": "A Morichetta"
    },
    {
      "affiliations": [
        "University of Camerino, School of Hospital Pharmacy, Camerino, Italy"
      ],
      "name": "F Spaccesi"
    },
    {
      "affiliations": [
        "University of Camerino, School of Hospital Pharmacy, Camerino, Italy"
      ],
      "name": "S Cioppettini"
    },
    {
      "affiliations": [
        "Ast Macerata, Hospital Pharmacy, Macerata, Italy"
      ],
      "name": "J Montecchia"
    },
    {
      "affiliations": [
        "Ast Macerata, Hospital Pharmacy, Macerata, Italy"
      ],
      "name": "L Scoccia"
    },
    {
      "affiliations": [
        "University of Camerino, School of Hospital Pharmacy, Camerino, Italy"
      ],
      "name": "C Cifani"
    }
  ],
  "title": "4CPS-169 Therapeutic appropriateness in oncologic immunotherapy: the role and value of the hospital pharmacist",
  "uid": "23e34aae-c2b1-5e8d-992c-f2606af62514"
}