Seminar E12: Sustainable remuneration

Overview of the findings: hospital pharmacy

1

Jacqueline SurugueMember of the FIP Working Group on Sustainability of Pharmacy Services

Past President of the FIP Hospital Pharmacy SectionPast President of the European Association of Hospital Pharmacists

Member of the Board of Hospital section Council at the French Order of PharmacistsHospital Pharmacist, Chief of Department Centre Hospitalier Georges Renon, 79000 NIORT, France

Seminar E12: Sustainable remuneration

Overview of the findings: hospital pharmacy

2

No conflict of interest

Jacqueline Surugue, FIP congress, Düsseldorf, 1 October 2015 3

PHARMACY

The Society

Health Care Sector

Expectations:

Access to medicines & health care products…Safe, effective, efficient, responsibleuse of medicines…Health outcomes….Cost effective solutions.

Findings in Hospital Pharmacy:The state of art

Responsibility

Accountability

Jacqueline Surugue, FIP congress, Düsseldorf, 1 October 2015 4

PHARMACY

The Society

Health Care Sector

Contract

No contract

Expectations:

Access to medicines: health care products…Safe, effective, efficient, responsible use of medicines…Health outcomes….Cost effective solutions.

Findings in Hospital Pharmacy:The state of art

Accountability

Responsibility

Jacqueline Surugue, FIP congress, Düsseldorf, 1 October 2015 5

PHARMACY

The Society

Health Care Sector

Extended roles for Hospital pharmacists:

Adjustments to hospitalchanging worldNew services…New developments…New responsibilities…

Contract ? 

Findings in Hospital Pharmacy:The state of art

Jacqueline Surugue, FIP congress, Düsseldorf, 1 October 2015 6

Findings in Hospital Pharmacy:A different model from community Pharmacies’

PHARMACY

Community pharmacists salaries depend on a multitude of factors.

Hospital pharmacistsare payed a fixed salary.

The activities they develop are remuneratedalong with other hospital services.

Jacqueline Surugue, FIP congress, Düsseldorf, 1 October 2015 7

PHARMACY

HOSPITAL BUDGETContracts

Findings in Hospital Pharmacy:A different model from community Pharmacies’

Jacqueline Surugue, FIP congress, Düsseldorf, 1 October 2015 8

Findings in Hospital Pharmacy:Hospital pharmacies funding

Capitation fee

Fee for service

DRG (Diagnostic Related Groups)

In most of the responding countries (n=23),hospital Pharmacy remuneration models

are integrated with those of the hospital itself….

…allowing the hospital Pharmacya portion of the global hospital budget.

Jacqueline Surugue, FIP congress, Düsseldorf, 1 October 2015 9

PHARMACY

Discounts

Purchasing GroupsNegociation with Industry

Clawbacks

HOSPITAL BUDGET

Findings in Hospital Pharmacy:Hospital pharmacies funding

Clinical trials

Incentives

Only 2 responding countries confirmed hospital pharmacy

remuneration systems providingincentives for expanded services.

Different modelsDifferent complexities

Outpatient pharmacy

Jacqueline Surugue, FIP congress, Düsseldorf, 1 October 2015 10

Health at a Glance 2013 - © OECD* 2013

Hospital beds per 1 000 population, 2000 and 2011 (or nearest year)

Other findings in Hospital Pharmacy

*OECD: Organisation for Economic Co‐operation and Development

Number of hospitals per population

Number of hospital beds per population

Health at a Glance 2011: OECD Indicators - © OECD 2011

Jacqueline Surugue, FIP congress, Düsseldorf, 1 October 2015 11

Average length of stay in hospital for all causes, 2000 and 2009 (or nearest year)

Other findings in Hospital Pharmacy

Jacqueline Surugue, FIP congress, Düsseldorf, 1 October 2015 12

Other findings in Hospital Pharmacy

Number of hospital pharmacies per population

*FTE defined as > 30 hours per week

FTE* Pharmacists per 100 bedsOut of 19 answers for that question,

14 reported havingat least 1 FTE Pharmacist

% of hospitals with a hospital pharmacy

For 100,000 inhabitants:

Japan : 6.7 Nigeria: 0.06

Sweden, Switzerland, Israël, Germany, Singapore: relatively

low number

31 answers for that question

• Shift from products focused models to more service-focused model, more focused on patient’s needs

• Simplify too complicated models, reduce complexity• Build remuneration model with an evidence based approach, on an evidence-informed

framework• Use pre established transparent criteria, including measures of and incentives for quality• Communicate! Make those criteria visible to patients, payers, and political decision makers

Jacqueline Surugue, FIP congress, Düsseldorf, 1 October 2015 13

Recommandations from the Report:for the sustainability of pharmacy services in Hospital pharmacies 

These are the Report’s key messages to promote, value and support the expanding role of hospital Pharmacists

while maintaining the infrastructure of Hospital Pharmacies

Seminar E12: Sustainable remuneration

Overview of the findings: hospital pharmacy

14

Thank you for your attention