Miguel Angel Calleja – President, SEFH, Spain

Miguel Angel Calleja, president of the Spanish Society of Hospital Pharmacists (SEFH) introduces the society and the important role it plays in Spain’s healthcare system as the perfect partner for the new government. Furthermore, he highlights the strides they are taking to implement new digital technologies into hospital pharmacies across the country.

Can you please start by introducing SEFH to our international readers?

Here at SEFH, we represent hospital pharmacists in Spain’s healthcare system. The main goal of our society is to teach and educate all the hospital pharmacists, aiming to improve all their skills to reach the best health outcomes possible. Our teaching programs range from logistics and management to procurement and technology. In addition, we conduct a therapeutic assessment for new and innovative drugs entering the market, evaluating their efficiency, safety, and convenience for the patient, mainly looking at the pharma-economic aspect of the drug. Looking at the structure of the society, we have several different directors dedicated to different aspects, with a director for innovation and research, a teaching director, a publication director and finally a coordinator of communication.

Spanish patients are attended to by the hospital pharmacists that we represent, for example, outpatients with HIV or multiple scoliosis who come to the hospital to have their drugs dispensed. We represent just over 3500 associates and have 23 working groups under the umbrella of the society. These working groups are composed of hospital pharmacies working in specific areas, such as those in intensive care, emergency care, degenerative diseases, HIV and so on. 800 of our associates are integrated into these active working groups, allowing SEFH to train and develop research projects and papers for these specific topics, which we can further extend to all our members.

What have been the main achievements of your strategic plan over the past three years?

The main achievement since 2015 is the improvement of the educational aspect of the hospital pharmacies. We have worked with the oncology and mental health Board of Pharmacy Specialists (BPS) to create a masters level at university in anti-microbial drugs, in collaboration with the Spanish Society of Infectious Diseases.

Furthermore, we have improved our relationship with the national administrations along with the different scientific societies and patient associations. Over the past three years, we have reached significant agreements with the oncology society, the respiratory society, and the infectious diseases society. Alongside the agreements related to the teaching programs we will offer, we have also collaborated on publishing scientific papers and information in our newsletter. Finally, we promote through social media the different societies and associations we work with, enabling the voice of the patient to become stronger and putting the patient at the center of our activities and projects.

Our strategic plan is to work with personalized medicines, as we feel that this is the future and a very important tool. In the hospital pharmacy, we work mainly with the therapy or the diseases, however, no two patients are the same and all patients need a personalized therapeutic plan, so this is something we can expand on.

What is your assessment of SEFH’s collaboration with the industry?

Again, in the recent years, we have had a better and stronger relationship with the industry, collaborating with the different pharmaceutical companies in all the teaching and research programs we create. For example, MAPEX is an important project we have collaborated with the industry on, working towards the systematic standardization of outpatient treatment.

Furthermore, if a pharmaceutical company has a drug for a specific therapeutic area and we also have a working group in that area, then we will invite both parties to evaluate and further understand the drug from both perspectives. In some situations, we are in a different part of the value chain. Therefore, it is important to sit with the industry and gain different perspectives on how we can improve in the hospital pharmacies. To recognize this relationship, we hold an award every year at our annual meeting to praise the best companies that we work with and have done so for the past eight years.

Looking towards digital technology, how well embraced are these initiatives in the hospital pharmacists?

Back in 2015, at the start of the new strategic plan, the society conducted a survey of hospital pharmacists and we plan to conduct an updated version next year. Looking specifically at digital technologies, they were mainly implemented in logistics sections of our work, with 60 percent of hospital pharmacies implementing digital technologies. However, this figure needs to improve, especially when we analyze the area of outpatients, as only 12 percent have embraced digital technologies. 85 percent of our financial budget is dedicated to outpatients, so it is important to use these finances to improve this section and increase the reception of digital technologies.

We have a strategy in place with the National Drug Agency to create a guide to explain the quality criteria needed in the clinical and compounding rooms, which can be advance with the use of digital technologies. We have traveled to the different autonomous regions to discuss these improvements and the investments into new technologies that are needed to increase quality. The society does not decide how much money goes to the hospital pharmacists, this falls to the health ministers. However, we are pushing to have this investment at the highest point of their agenda and for them to invest in hospital pharmacy.

What evidence do you bring to the Ministry of Health that if they invest in hospital pharmacies the healthcare system will benefit?

We have many different publications and scientific papers, with the main outcome being that if the ministry invests one euro in the hospital pharmacies they will have a return on investment of five euros. In addition, investing in digital technologies in an outpatient unit can save more than two million euros in a year. Although the expenditure does not decrease, the whole process becomes more efficient and managed better, and we can focus less on the logistics and place our attention elsewhere.

What are the main challenges that present themselves in the healthcare sector for hospital pharmacies?

There are many different challenges that present themselves working in the healthcare sector. Firstly, the regulations agreed on back in 2012 for outpatients and patients in nursing homes have only been implemented fully in two of the 17 different regions in the country. We need more pharmacists in the hospitals to implement this regulation and have better clinical quality. Related to this, the past ministry requested that we change our specialty to include primary care, which is not part of the community pharmacy. We are currently debating this structure change internally but we are working as well with the ministry to agree on an effective change.

Looking towards the future, the main challenges will come from a shift towards individualized therapies and the relationship with other professionals to improve the innovation and how the hospital pharmacists promote these new drugs. Currently, we are well integrated into the management of both commercial and non-commercial clinical research. I would like to see the country enroll more patients than other countries and I think hospital pharmacists can be part of this.

With the new government coming into power, what incentives would you like to see from the new Ministry of Health?

The Ministry will find a perfect partnership with SEFH to improve the healthcare system, however, I ask the new government to have an open mind and work with the society to communicate problems and help work with us to improve the system, especially regarding patient safety and drug traceability.

Looking towards the future, how do you see the role of the hospital pharmacists evolving in the future and what will be the top priorities?

Looking at the history of SEFH, we have played a very important role and have been the key to welcoming many new drugs into the system. I expect we will continue to play this role, although become more diversified and complement our role with more clinical activities and a bigger presence within the sector. My main aim is to have a specific pharmacist for each of the different departments in a hospital. Many of my colleague’s question whether this is even achievable, but the hospitals will also have to evolve with time and a change in mindset will be beneficial to all.

Moreover, a priority for the society will be to become patient orientated and not looking only at the drug we administer. I would like to see the pharmacists understanding that their role does not end when they give a patient their drug, but also the follow-up process is part of their job because we are there to fully help the patient in all of their health problems.

Finally, the society will continue to make improvements regarding personalized medicine from a general point of view. We need to think out of the box and start climbing out of the cave we have become comfortable within; however, we are making large strides in the right direction.