EM19: PHarmacy Analysis Researcher grOup (PHARO Group)

This research group originated more than 10 years ago around the research questions that arose in the field of hospital pharmacy at the University Hospital of Puerto Real, in three fundamental areas: the evaluation and positioning of new medicines, the use of medicines /pharmacotherapeutic follow-up and information on medications. The pharmacy of the University Hospital of Puerto Real has a Drug Information Center and the group has participated in various collaborative research initiatives in the GENESIS (SEFH) and GHEMA-SAFH groups, participating in their management and leading projects such as the Pharmacotherapeutic Guide for Andalusian Hospitals (SAS-SAFH collaboration).

Its main publications have been methodological contributions in drug evaluation, such as the Guide for Equivalent Therapeutic Alternatives, a check-list for the evaluation of indirect comparisons, a method for calculating survival by area under the curve in Kaplan-Meier analysis and a checklist to evaluate the applicability of results of subgroup analysis accompanied by an interaction calculator; comments on clinical trials and other studies, with letters to the editor in journals such as N Engl J Med, Am J Cardiol or Stroke, drug utilization studies and numerous evaluations of new drugs including indirect comparisons and network meta-analysis, using the GENESIS methodology , in whose development we participate continuously. In the last two years, he has developed a collaboration with EASP health economists, producing several pharmacoeconomic analyzes of new medicines.

The group has received several awards (2 first prizes at SEFH congresses and 3 first prizes at SAFH congresses). It has an important teaching activity, including 8 annual rotations from other Andalusian centers and from other CCAAs to learn the evaluation of new drugs, which also generate joint publications.

• Methodological advances in the evaluation of drugs and their therapeutic positioning. It is about advancing in the analysis of benefits, risks and costs of new drugs in areas that present uncertainties, in order to facilitate an evaluation and introduction into therapy according to the available evidence and with efficiency criteria. It focuses on specific research topics, such as:
• - Analysis of the benefit in "time-to-event" survival studies.
• - Assessment of indirect comparisons and network-meta-analysis.
• - Assessment of the clinical applicability of subgroup analyzes according to effect modifier factors.
• Health results: Analysis of the benefit/risk ratio of drugs in clinical practice. The aim is to analyze the effectiveness and safety data of certain target drugs in real clinical practice, based on the historical data recorded in DIRAYA in all Andalusian hospitals, which allow maximizing the ratio/benefit/risk and benefit/cost in pharmacotherapy. . The analysis of emerging therapies and targeted therapies according to markers of effect is prioritized. Likewise, it tries to take advantage of the "big data" available in the Andalusian registration systems on morbidity and pharmaceutical prescription, integrate them with valid criteria and exploit information that may be useful in decision-making on the appropriate use of therapeutic resources.
• Pregnancy and Medication Safety Information. It is about improving the available information, analyzing and integrating the evidence so that it can be useful for clinical decision-making. It is an area with significant potential for improvement due to the lack of sufficiently detailed databases prepared with strict criteria from the scientific point of view.

Health results Evidence based medicine Immunotherapy Clinical decision making

• Principal Investigators:
  • Emilio Jesús Alegre del Rey (PI).
  • Silvia Fénix Caballero (Co-PI).
• Investigators:
  • Jorge Díaz Navarro.
  • Esmeralda Ríos Sánchez.
  • Carmen Martínez Díaz.
  • Julio Outón Velázquez.

1. Authors: Olry de Labry Lima A, Gimeno-Ballester V, Ríos Tamayo R, Epstein D, Matas Hoces A, Ríos Sánchez E, García Mochón L, Alegre-Del Rey EJ. Title: Cost-effectiveness of lenalidomide maintenance in patients with multiple myeloma who have undergone autologous transplant of hematopoietic progenitor cells. Journal: Bone Marrow Transplant. Year, volume, first and last pages 2019 May 31. doi: 10.1038/s41409-019-0574-5. [Epub ahead of print]. Impact factor: 4,674. Quartile/Decile: first quartile.
2. Authors: Camean-Castillo M, Gimeno-Ballester V, Rios-Sanchez E, Fenix-Caballero S, Vázquez-Real M, Alegre-Del Rey E. Title: Network meta-analysis of tofacitinib versus biologic treatments in moderate-to-severe rheumatoid arthritis patients. Journal: J Clin Pharm Ther. Year, volume, first and last pages 2019 Jun;44(3):384-396. Impact factor: 2,167. Quartile/Decile: third quartile.

1. Authors: Gil-Sierra MD, Fenix-Caballero S, Alegre-del Rey E. Title: Pembrolizumab plus Chemotherapy in Lung Cancer. Journal: N Engl J Med. Year, volume, first and last pages 2018;379(11):e18. Impact factor: 70,670. Quartile/Decile: First quartile and decile.
2. Authors: Olry de Labry Lima A, Matas Hoces A, Alegre Del Rey EJ, Gimeno Ballester V. Title: Cost-effectiveness of Evolocumab. Response. Journal: Rev Esp Cardiol (Engl Ed). Year, volume, first and last pages 2018;71(12):1090. Impact factor: 5,126. Quartile/Decile: first quartile.
3. Authors: Olry de Labry Lima A, Gimeno Ballester V, Sierra Sánchez JF, Matas Hoces A, González-Outón J, Alegre Del Rey EJ. Title: Cost-effectiveness and Budget Impact of Treatment with Evolocumab Versus Statins and Ezetimibe for Hypercholesterolemia in Spain. Journal: Rev Esp Cardiol (Engl Ed). Year, volume, first and last pages 2018 Dec;71(12):1027-1035. Impact factor: 5,126. Quartile/Decile: first quartile.

1. Authors: Alegre-del-Rey EJ, de la Nogal Fernández B, Briceño-Casado P. Title: Nivolumab and Ipilimumab in Advanced Melanoma. Journal: N Engl J Med. Year, volume, first and last pages 2017;377(25):2503. Impact factor: 70,670. Quartile/Decile: First quartile and decile.
2. Authors: Alegre-Del Rey EJ, Fénix-Caballero S, Díaz-Navarro J. Title: [Controversies about the mechanism of postcoital levonorgestrel: evidences according to the decrease of pregnancies]. Journal: Farm Hosp. Year, volume, first and last pages 2017;41(6):696-697. Impact factor: no impact factor. Quartile/Decile.
3. Authors: García de Paredes Esteban JC, Alegre Del Rey EJ, Asensi Díez R. Title: Docetaxel in hormone-sensitive advanced prostate cancer; GENESIS-SEFH evaluation report. Journal: Farm Hosp. Year, volume, first and last pages 2017;41(4):550-8. Impact factor: no impact factor. Quartile/Decile.
4. Authors: Alegre del Rey EJ, Díaz Navarro J, Fénix Caballero S, Pardo MC, Pérez T, Figueroa Murillo E, Moreno Santos MA, Martínez Díaz C. Title: Area-based method for assessing survival benefit in Kaplan-Meier curves. Journal: Eur J Clin Pharm. Year, volume, first and last pages 2017;19(2):105-11. Impact factor: 0,13. Quartile/Decile: 4th quartile.

1. Authors: S. Fenix-Caballero, J. Diaz-Navarro, B. Prieto-Callejero, E. Rios-Sanchez, E.J. Alegre-del Rey, J.M. Borrero-Rubio. Title: New graphic AUC-based method to estimate overall survival benefit: pomalidomide reanalysis. Journal: J Clin Pharm Ther. Year, volume, first and last pages 2016;41(1):1-3. Impact factor: 1,679. Quartile/Decile: third quartile.
2. Authors: Emilio Jesús Alegre del Rey; María Eugenia Blanco Rivas; Francisco Javier Arenas Villafranca. Title: Necitumumab: Looking for the lost subgroup. Journal: Eur J Clin Pharm. Year, volume, first and last pages 2016. 18(6):417. Impact factor: 0,13. Quartile/Decile: 4th quartile.
3. Authors: Emilio Jesús Alegre-del Rey, Silvia Fénix-Caballero, Jorge Díaz-Navarro y Esteban Rodríguez-Martín. Title: Píldora postcoital: un debate científico necesario. [The morning after pill, a necessary scientific discussion]. Journal: Gac Sanit. Year, volume, first and last pages 2016;30(5):401–403. Impact factor: 1,768. Quartile/Decile: second quartile.

1. Authors: Alegre-del Rey EJ, Fénix-Caballero S, Díaz-Navarro J, Rodríguez-Martín E. Title: Post-fertilization effect of postcoital levonorgestrel. Journal: Eur J Clin Pharm. Year, volume, first and last pages 2015;17(6):432-5. Impact factor: 0,13. Quartile/Decile: 4th quartile.

1. Authors: Alegre-del Rey EJ, Fenix-Caballero S, Castaño-Lara R, Marquez-Saavedra E. Title: Evaluación y posicionamiento de medicamentos como alternativas terapéuticas equivalentes. [Assessment and positioning of drugs as equivalent therapeutic alternatives.]. Journal: Med Clin. Year, volume, first and last pages 2014;143:85-90. Impact factor: 1,417. Quartile/Decile: second quartile.
2. Authors: A Ortega; MD Fraga; EJ Alegre del Rey; F Puigventós Latorre; A Porta; P Ventayol; JM Tenias; NS Hawkins; MS Caldwell. Title: A checklist for critical appraisal of indirect comparisons. Journal: Int J Clin Pract. Year, volume, first and last pages 2014;68(19):1181-89. Impact factor: 2,566. Quartile/Decile: first quartile.
3. Authors: María de las Aguas Robustillo Cortés; MªR Cantudo Cuenca; R Jiménez Galán; Yolanda Borrego Izquierdo; Emilio Jesús Alegre del Rey; Patricia Monje Agudo. Title: Indirect comparison of denosumab versus pamidronate in the treatment of bone mestastases in breast cancer. Journal: Eur J Clin Phar. Year, volume, first and last pages 2014;16(3):213-6. Impact factor: 0,13. Quartile/Decile: 4th quartile.