rated according to the relevant criteria. Input is also
sought from the pharmaceutical industry.
For the LMWH product selection at the University
Hospital in Gdansk, a recently updated matrix was
available in English. This was reviewed to ensure
relevance in Poland and translations of the main
headings in the matrix were made available in Polish.
STEP 1 – Element 2
SOJA evaluations by clinicians and
pharmacists from the hospital formulary
committee
The interactive product selection feature of STEP 1
is based on System of Objectified Judgment Analysis
(SOJA) technology. SOJA facilitates rational drug
selection and streamlines better quality in prescribing
based on an objectified consensus among clinicians
and pharmacists.
Using the matrix methodology, SOJA sessions are
organised among local clinicians, national formulary
committees or other staff at a national, regional
or hospital level. Product selection is facilitated by
interactive software, with participants logging on
individually to a secure website environment or in
a live group with tablet PCs (iPad, Android)
or laptops. The interactive sessions facilitate
transparency between clinicians, and exchange of
opinion and consensus about medicines to include
in the formulary is easily reached.
Preparation for sessions on the selection of LMWHs
at the University Hospital in Gdansk involved:
• In consultation with the Medical Director,
11 clinicians and pharmacists were invited to
participate. Staff were selected either because they
were a local formulary committee member or
because of their knowledge of LMWHs.
• The necessary IT infrastructure was set up by
authorising access to confirmed participants of
the LMWH session and assigning passwords and
logins allowing them to complete the exercise at
a convenient time.
It took approximately two months to confirm
participants to the clinical selection panel and to
arrange the IT infrastructure (until end of March
2017). All participants completed their product
selections within the allocated four-week period
(until the end of April 2017).
An evaluation team consisting of the authors of
Table 2
Summary of the main project inputs and timings
Main project input Timing
Initial meeting. Study work and workshop –
presentation of methodology, training, discussion
with originator and experts 18.01.2017
Preparation of Polish version of STEPSelect for the
LMWHs 19.01–14.02.2017
First phase of the procurement – definition of the
parameters for clinical evaluation with STEPSelect in
collaboration with the Pharmacotherapy Committee
of the hospital 03–17.04.2017
Second phase of the procurement – SOJA evaluation
with the use of STEPSelect 17–30.04.2017
Final meeting of the Pharmacotherapy Committee
to approve the clinical parameters evaluation and
selection of one main and one rescue drug to be
procured 07.06.2017
Beginning of the public tender 20.07.2017
End of the public tender 22.09.2017
this report evaluated the outcome and made product
selections (May 2017). The selected products were then
evaluated according to their budget impact on the
hospital budget (STEP 3) and a procurement process
was initiated in July 2017 (STEP 4) and completed
in September 2017. A summary of the main project
inputs and their timing is shown in Table 2.
Results
In 2016, the University Hospital in Gdansk procured
three different LMWHs, which, for reasons of
confidentiality, are named ‘Drug A’, ‘Drug B’ and
‘Drug C’. These three products were used in the
hospital in 18 different formulations. In addition, the
hospital had one LMWH rescue medication (‘Drug D’).
The total volume of this segment at the hospital in
2016 was €234,389.
Using the STEPSelect methodology, the
Pharmacotherapeutic Committee of the hospital
decided to reduce the number of available products
from three to one and to make 17 different
formulations of this product available for use in the
hospital. The Committee reached this decision on
the basis of the scientific evidence presented in the
LMWH matrix. In particular, the Committee felt that
a reduction of available products from three to one
would not be detrimental to treatment options for
patients. In addition, it was decided to switch the
rescue formulation from Drug D to Drug A.
In an ensuing tender initiated by the hospital,
the total volume of Drug A procured was €203,058;
this meant a reduction in overall volume of 13.4%,
representing a saving to the hospital in the region
of €31,331 on an annual basis (Table 3). In procuring
this volume, the unit component of the procurement
was the same as for 2016. This means that the overall
saving was entirely due to a unit cost price reduction.
Discussion
It took seven months to introduce STEPSelect at
the University Hospital in Gdansk and to develop
and implement a project focusing on the selection
and procurement of LMWHs. This therapeutic
hospitalpharmacyeurope.com | 2018 | Issue 90 | 13