9 year experience of a National Pharmacy Association with AEGATE

Luc Adriaenssens, General Manager APB

Belgian Association of Community Pharmacists

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Table Of Content

• Introduction of APB

• Introduction of UBC’s in Belgium, legislation and outcome

• Why did APB enter into a collaboration with Aegate?

• How do Aegate and APB work together?

• The Aegate APB experience

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Introduction APB

Aegate Confidential3

Introduction APB

• Algemene Pharmaceutische Bond – Association Pharmaceutique Belge – BelgianAssociation of Community Pharmacists

• National professional association of independant community pharmacists

• 4.420 members

• Professional defense and evolution: politics, National Health Insurance Institute, sickness funds,…

• Support to pharmacists: 9 main services

science – laboratory – legal – statistics – economy – HR – marcom – IT - tarification

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Introduction of UBC’s in Belgium, legislation and outcome

Aegate Confidential5

• Government measure against reimbursement fraud

• Expected savings: 6 million Euro per year -> never proven

• Manufacturers obliged to submit the released UBC’s to the reimbursement authorities within a few months after their release.

• Reimbursement authorities admit the control system is ineffective

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2004: Introduction serialisation reimbursed products

Why did APB enter into a collaboration with Aegate?

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• Patient safety !

• Four collaboration items:– Recall warnings

– Expiration warnings

– Patient counselling messages

– Authentication requirements

• Start: 2006

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Collaboration APB with Aegate

Recall warnings

• All recalls (product redraws) are communicated to the Belgian pharmacists by APB

• Classic communication channels do not prevent that recalled products still reach the patient– Time lack between decision, communication, reaching the pharmacist

– Pharmacist can still forget to discard the products from his stock

• Aegate offers the possibility to start the recall communication the moment the decision is made

• Pharmacist automatically alerted the moment he is at the point of dispensing a recalled product

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Expiration warnings

• Current bar codes: no expiration dates

• All expiration dates need to be checked visually -> time consuming and error risks

• When Aegate receives the tags from the manufacturer to download into the Aegate database, these can be linked to expiration dates

• Pharmacist automatically alerted the moment he is at the point of dispensing an expired or almost expired product

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Patient counselling messages

• APB: own product information system (DELPHI) and is integrated in all dispensing softwares in Belgium.

• DELPHI: scientific information on the products (including contra indication, alerts, incompatibility alerts, etc…)

• APB finds the Aegate messaging capability complementary to DELPHI because of:– Real time communication (communication over short periods of time)

– Communication is always done at time of dispense (until filtered)

– Possibility of 2 way communication (internet connection)

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• APB wanted to avoid that the authentication requirement would increase the costs for the pharmacist and impact his workflow

• By choosing early on Aegate as an authentication partner APB believes it has created a strong position for the pharmacists in the negotiations between stakeholders for selecting an authentication service provider

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Preparation for the authentication requirement

How do Aegate and APB work together?

Aegate Confidential13

14 Aegate Confidential

APB has direct access to the Aegate system for Recall warnings and new product information

• All messages displayed in the Aegate system are first submitted to a panel of 20 pharmacists member of APB

• Panel is anonymous to Aegate and industry

• Panel members change over time

• Panel gives advice on content and format

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Advisory panel for counselling messages created by the industry

Monthly reporting

Pharmacy Status:

Pharmacy Status Total to date

Number Actively Scanning 2483

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Monthly reporting

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Product Status:

Product Status Cumulative total

to date

Companies who have joined 19

Number of recalled Product Notifications 777

Products that can be authenticated 1845

Recalled product notifications that are currently live 130

Special Messages added 1533

Total unique pack IDs in database (million) 125.28

Monthly reporting

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Safety Notifications delivered to Pharmacies:

Safe. Notif. Deliv. Pharmacies Last 12 months

(to date)

Already Dispensed Elsewhere (Distinct Packs) - Warnings* 276

Items Authenticated 630669

Notification that the item has been recalled (Distinct Packs) 815

Notifications that an Item has Expired (Distinct Packs) 723

Warning that packs are soon to Expire (Distinct Packs) 528

Monthly reporting

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System Performance:

System Performance Mean Response Time, 12 Months

Pharmacy End to End response time (Average) 184 ms

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300

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2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

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Tim

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Average response time by year

Quarterly meetings

• Feedback from members

• Future projects

• Common communications

• FMD status and Belgian stakeholder position

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The Aegate APB experience

Aegate Confidential21

Multiple scan events

• Aegate notifies APB immediately when a suspicious multiple scan event occurs

• Aegate conducts an investigation and informs APB and the manufacturer on the outcome

• Manufacturer decides on action steps in consultation with reimbursement authorities and APB

• All events are handled swiftly by Aegate

• This results in:– Savings for the pharmacist: who is otherwise at risk of not getting reimbursed

– Savings for the industry: who is otherwise always obliged to do a full recall

– Extra patient safety

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• On 2nd of December 2014 Aegate received a multiple scan alert on their system. A unique barcode on an antibiotic from a top ten pharmaceutical company was being scanned in 5 different pharmacies .

• The Belgian Aegate team immediately started an investigation and discovered that an entire batch was labelled with the same barcode. They promptly informed the manufacturer and the Belgian pharmacy association (APB).

• Reimbursement authorities (RIZIV/INAMI) were contacted and measures were taken to re-label the remaining products of the concerned batch.

• It took less than 8 hours from the first multiple scan to the resolution of the issue.

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Outcome of a recent multiple scan event

Recalls

• In 2014 the Aegate system prevented the dispensing of 815 recalled packs. Possibly preventing serious harm to the patient.

• Without the Aegate system in place these packs would have reached the patient.

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Antibiotics campaign

25 Aegate Confidential

Conclusions

• APB supports the Aegate system because:– it doesn’t impact the workflow of the pharmacist

– It comes free of charges for our members

– It brings added value through recall warnings, expiration warnings and messaging

– The system increases the safety of our patients

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THANK YOU !