applied research
STEPSelect for the rational
selection and procurement
of LMWHs in a Polish hospital
Tomasz Stefaniak
MD PhD
Dept of General,
Endocrine and Transplant
Surgery, Medical
University of Gdansk,
Poland
Mike Scott PhD
Medicines Optimisation
Innovation Centre,
Northern Ireland
Rob Brenninkmeijer MSc
Digitalis MM Ltd, Ireland
Rob Janknegt MSc PhD
Digitalis MM Ltd, Ireland
Teresa Frackowiak
MSc PhD
Department of
Biopharmaceutics and
Pharmacodynamics,
Medical University of
Gdansk, Poland
Anita Hogg MSc
Medicines Optimisation
Innovation Centre,
Northern Ireland
Frans van Andel MSc
MPH PhD
Medicines Optimisation
Innovation Centre,
Northern Ireland
Abstract
AIMS To introduce Safe Therapeutic Economic
Pharmaceutical Selection (STEPSelect), a drug
selection and procurement system, to a Polish
university hospital and determine if credible results
could be achieved.
Methods A project was established at the
University Hospital, Gdansk to assign a hospital-
based panel of doctors and pharmacists to select
low molecular weight heparins (LMWHs) using
STEPSelect. Products selected were then procured
by the hospital.
results Using STEPSelect, the clinical panel
opted to select one LMWH instead of three in the
previous year. Procurement of this product
resulted in a cost saving of 13.4% compared with
the previous year.
conclusion STEPSelect should be extended in
Poland as similar efficiencies can be expected for
LMWHs in other hospitals and for other therapeutic
classes. Efficiencies of scale can be expected for
high volume/cost medicines.
In Poland, the process of selecting medicines
for the hospital formulary is often not well
developed. 1 A lack of transparency, unclear procedures
and knowledge of modern pharmacotherapy are
contributing factors. 2,3 There is a need to focus on
clinical efficacy and safety and introduce transparent
and accountable methods to select medicines for
a formulary.
Developed in 2006 by the Northern Ireland
National Health Service and Digitalis MM Ltd,
STEPSelect is designed to select and procure
medicines based on clinical efficacy, safety, side
effects, drug interactions, ease of administration
and clinical documentation as well as cost–benefit
analysis. STEPSelect increases the transparency of
decision making and facilitates rational formulary
management.
STEPSelect is an important component of
medicines optimisation, and Northern Ireland is the
only region in Europe with a quality management
framework in this field. 4,5 Initial analytical work in
Northern Ireland revealed that the selection and
procurement of medicines within the National Health
Service was not fully transparent and primarily
Key messages
What is already known on this subject
• STEPSelect has been sucessfully implemented
in Northern Ireland for the rational selection of a
range of medicines and medical devices delivering
efficiencies of up to 25%
• STEPSelect has been identified as an example
of regional best practice in Northern Ireland
• This project was designed to test the introduction
of STEPSelect in Poland and make recommendations
for wider application of STEPSelect in terms of both
therapeutic classes and in other hospitals
What this study adds
• STEPSelect is transferable to other countries and
healthcare systems, evidenced by the successful
introduction in Poland
• STEPSelect delivered efficiencies of 13.4% in the
selection of LMWHs in a Polish university hospital
• Clinicians and pharmacists liked the combination
of a knowledge system (matrix production) and a
transparent decision making tool (web-based SOJA)
hospitalpharmacyeurope.com | 2018 | Issue 90 | 11