Significant Changes Associated with the Transition from Outsourcing to In-hospital Therapeutic Drug Monitoring of Novel Antiepileptics

• Published in: YAKUGAKU ZASSHI Vol. 140; no. 8; pp. 1035 - 1040
• Main Authors: Suetsugu, Kimitaka, Yamamoto, Nanae, Shigematsu, Tomohiro, Kobayashi, Daisuke, Tsuchiya, Yuichi, Nakayama, Yurie, Tsuji, Toshikazu, Watanabe, Hiroyuki, Kanaya, Akiko, Masuda, Satohiro, Egashira, Nobuaki
• Format: Journal Article
• Language: Japanese
• Published: The Pharmaceutical Society of Japan 01.08.2020
• Subjects: in-hospital measurement; LC/MS; novel antiepileptics; therapeutic drug monitoring
• ISSN: 0031-6903; 1347-5231
• DOI: 10.1248/yakushi.20-00001

For many of the novel antiepileptics, immunoassays, used for routine therapeutic drug monitoring (TDM), cannot be used. We could monitor eight novel antiepileptics using an LC/MS method since July 2017. The purpose of this study was to evaluate the significant changes associated with the transition from outsourcing to in-hospital monitoring of novel antiepileptics. The number of measurements of novel antiepileptics was significantly increased during the first (p<0.01) and second (p<0.001) years of in-hospital monitoring as compared to that one year prior to in-hospital monitoring which was outsourced. The proportion of measurements of novel antiepileptics to all antiepileptics was 19.7%, 31.1%, and 38.4% during outsourcing, and first, and second years of in-hospital monitoring, respectively. The measurement cost was significantly reduced during the first (p<0.001) and second (p<0.001) years of in-hospital monitoring as compared to that during outsourcing. In addition, the revenue from TDM of antiepileptic drugs was significantly increased during the first (p<0.05) and second (p<0.01) years of in-hospital monitoring as compared with that during outsourcing. In conclusion, the switch from outsourcing to in-hospital monitoring led to an increase in the number of orders, a reduction in the measurement-related expenses of novel antiepileptics, and an increase in the revenue from TDM of antiepileptic drugs, which could promote the proper use of novel antiepileptics through TDM.