Pertinence of Off-label Prescriptions of Innovating and Expensive Drugs in a University Hospital

Amelie Falabregues , Marion Daul , Bertrand Pourroy , Laurence Gauthier-Villano , Pascale Pisano (1, 2) , Pascal Rathelot (3) , Bernard B. Vialettes (4)

1 VRCM - Vascular research center of Marseille
2 Physiopathologie de l'Endothelium
3 ICR - Institut de Chimie Radicalaire
4 NORT - Nutrition, obésité et risque thrombotique

Objectives. Pertinence of off-label prescriptions of innovative and expensive drugs needs a strict scientific appraisal to prevent adverse reaction risks and financial drift. Methods. Pertinence of such prescriptions has been analyzed in a University Hospital by bibliometric methods. Scientific publications issued from this clinical activity have been also evaluated. Results. Oncology differed from other clinical specialties by a better pertinence in justifying off-label prescriptions (good evidence level in 46% vs. 21%, scientific publications issued from A/B ranked journals: 51% versus 41%). Quality of scientific production from oncologists was also better (publication impact factor [IF] mean: 4.571 versus 2.245). Conclusions. The better pertinence of off-label prescriptions by oncologists in comparison to others clinicians' ones was mainly due to a shorter field of indications but also to a more efficient organisation such as systematic prescription by seniors, dedicated computerized provider order entry, multidisciplinary team meetings and collaborative culture.

Domains: Chemical Sciences

Amelie Falabregues, Marion Daul, Bertrand Pourroy, Laurence Gauthier-Villano, Pascale Pisano, et al.. Pertinence of Off-label Prescriptions of Innovating and Expensive Drugs in a University Hospital. Thérapie, 2015, 70 (5), pp.385--402. ⟨10.2515/therapie/2015008⟩. ⟨hal-01460568⟩