Need for of Long-Acting Psychotropic Injectables in a Pharmacy Setting
Technological advancement in the health care sector has been seen in different ways including increased knowledge, innovation, research, and medication that can solve human problems to guarantee the efficient provision of health care, quality, and affordable services. The pharmaceutical sector is one area that has evolved over the years due to increased research on medication and various treatment options for emerging diseases, mainly because modern medicine faces the challenge of addressing emerging lifestyle diseases among communities. In an attempt to treat multiple psychiatric disorders, pharmaceutical companies came up with antipsychotic medications in the early 1950s. These drugs have effectively treated diseases such as schizoaffective disorder, mania with psychosis, and schizophrenia ( Citrome, 2015 ).
Increased psychiatric cases in various health care facilities lead to a high need for these drugs. More people are now aware of mental illnesses caused by stress, such as depression. This is particularly the case for certain people within the population, with significant concerns about military veterans. Hospitals offering medical services to veterans and have the mission of providing holistic care and treatment to this group have considered various aspects of treatment to address the wide range of health issues faced by the growth. Most veterans are old hence suffering from age and lifestyle-related chronic diseases such as diabetes. The mental health challenges worsen this from their experiences as military personnel and family problems.
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Psychiatry patients suffer from anxiety and mental illnesses other than age-related diseases, with the most common one being depression. The use of these drugs to reduce anxiety symptoms in patients is closely associated with biopsychology, which is a division of psychology dealing with the functioning of the brain and how the brain is connected to the nervous system. Biopsychology links neurotransmitters' phenomenon to human feelings, thoughts, and reactions, hence explaining how and why people suffer from panic, anxiety, and various mental conditions ( Cusimano & VandenBerg, 2020) . These reactions are crucial in research relating to the medicine used in treating mental health conditions and nervous system diseases relating to the brain's instability. Biopsychology goes further into determining how genes affect reactions to a phenomenon occurring in the human environment. This explains why men have different mood patterns than women, a situation related to the changes in hormones within the female body. This explains why mental health cases vary between men and women in terms of the severity of the symptoms and the treatment options that work for each.
The second factor that impacts the need for long-acting psychotropic drugs as part of the treatment process for patients is implementing holistic patient care for patients. This means that patients receive personalized treatment. The implication is that patients will receive personalized treatments, increasing the need for these drugs for patients who need them since no alternatives will be offered as would be the case in traditional medicine. The need to LAIs by patients is not restricted within the holistic care approach. This means that patients who need the injections to reduce pain or for treatment have them administered to them as they need them. Traditional treatment of psychiatry cases was centered on treating patients through therapy.
Healthcare facilities offering psychiatry services must have a detailed budget for equipment, medication, and other resources to ensure that resources are allocated to all units and sectors based on their needs. These resources vary from machinery, medical supplies, finances to human labor. It is the management's role to ensure that it has a reasonable budget for this sector and meet the patients' requirements through the store. This means that decisions around budgeting for psychiatry units must be geared towards meeting the patients' needs. Funds budgeted for should be used as stipulated to avoid wastage. In terms of human resources, the drugs' administration will require special teams, especially nurses, since drugs are administered based on the needs of the patient. The team in charge of administering the medications must be thoroughly trained and understand its side effects.
Overview of the Product
Long-acting injectable (LAI) antipsychotics is a term used to define a pharmacologic approach that aims at treating patients who have schizophrenia who deteriorate due to lack of seriousness and not adhering to antipsychotic meds. Instead of the daily prescribed medicine-taking routine essential for oral antipsychotics, LAI antipsychotic meds are administered using the method of injections at regular intervals of two- to four-weeks ( Citrome, 2015 ) . The negative adverse effects of antipsychotic drugs coupled with the patients' skepticism of having an ailment, which is often experienced by persons who have schizophrenia, often lead to high non-adherence to antipsychotics in the treatment of schizophrenia. Schizophrenia is a severe psychological condition that inhibits the patients' ability to interpret reality, may manifest in some patients as a combination of hallucinations, delusions, and very disordered thinking and characteristics that interfere with daily functioning and can be incapacitating.
In as much as there is the widespread use of long-lasting injectable (LAI), antipsychotics (APS) have been faced with negativity and disapproval based on the fact that they are viewed as a punishment reprimand. However, LAI APs have over the years proved to be effective in schizophrenia and a host of other severe psychotic conditions because they guarantee even blood levels, leading to reduced levels of the risk of reversion ( Cusimano & VandenBerg, 2020) . The field of medicine has recorded a notable increase in curative prospects by introducing newer, second-generation LAI Aps. This has been made possible by the recent advancements in the field of medicine. Newer LAI Aps are radially administered and are more adjustable to rehabilitation programs ( Schreiner et al. , 2015). This has solved the severe issue of non-adherence to oral formulations, a problem since the introduction of long-acting injectable (LAI) antipsychotics in the year 1966.
Market Analysis
The psychiatry market in the United States has seen a rise in demand over the years, a situation that can be attributed to increased cases of mental health mainly associated with changes in lifestyle and the fact that mental health is now an issue that is open about in the country on various platforms. As a result, more people now come out to seek medical attention in case they experience the symptoms. The media, both mainstream and social media, has played an immense role in enlightening people on the symptoms of depression and how the same can be treated. Through such sensitization, cases of suicide, divorce, and crime or violence associated with mental health have reduced slightly in various States. Community outreach has also impacted the demand for long-acting psychotropic injections through outreach programs that reach out to domestic violence victims, veterans, drug addicts, and the community at large.
The increase in demand has also been brought about by accepting modern medical treatments by healthcare facilities addressing psychiatry cases. Modern medicine incorporates various aspects of treatment, including therapy and medication, implying that more healthcare facilities now use these injections as part of the treatment process for patients who need them. This increase in demand for such medicine makes it profitable for a pharmaceutical product to sell the drug to patients and clinics.
Market analysis should entail the buying price of the medication and required accessories. Facilities intending to implement the injections as part of the treatment should consider the availability of the same in the market based on the demand. This means that there is need for vetting of suppliers and determining their capabilities to satisfy the hospitals needs in the long term. Market analysis also entails a detailed research on the legal restrictions on the use of the injections as well as the culture of the majority of patients especially as it relates to mental health. Health care facilities should work hand in hand with other facilities and community centres offering the same services to determine the need of the injections in the communities they operate in and respond to this demand.
Operational Budget
The operational budget for administering the drug will entail short-term and long-term aspects of the plan. Short-term administration will require the acquisition of the medication, injections, and personnel training on the use. Other subsidiary items such as spirit and gauges will also be acquired. A cost-benefit analysis of the cost incurred and the benefit (measured in terms of patient outcomes and satisfaction) will be carried out. The operation budget items include;
|
Item |
Quantity |
Unit Price |
Budgeted Amount |
|
Items Administered |
4,000 |
$16 |
$64,000 |
|
Wages |
$16,000 |
||
|
Training Costs |
$4,200 |
||
|
Cost of materials and drugs |
$12,000 |
||
|
Misc. Direct Expenses |
$400 |
||
|
Indirect Expenses allocated to the unit (20% of fixed costs) |
$21,400 |
||
|
Net Profit or loss |
$22,000 |
The operations budget in place should cater for all the needs of the psychiatry units and support budgets running alongside it especially in cases where these units support patients from other units such as chronic disease patients. The management should have in place an operations budget for each unit and a comprehensive budget in line with the facilities goals and objectives. Budgets should include all the expected income and expenditure from the units. The operational budgets allows managers to determine the profitability and efficiency of their sections and work towards improving areas that are not efficient.
Monitoring and evaluating the budget will be carried out regularly to confirm that the drug administration is within the budgeted amount. The hospital will determine the revenue generated from the drugs as compared to the costs incurred. The operational budget will run in line with funds from other departments. No new staff will be hired to administer the drugs. However, existing practitioners will receive intensive training on the effects of the drug, the uses, and the intended purpose of the drug on the clinical process.
Capital Budget
Capital budgeting for this project will entail integrating the new medication into the pharmaceutical system of the hospital. A considerable amount will be spent acquiring the drug from suppliers through the procurement process. However, the hospital will determine the drug's estimated use to determine how much it needs to have in stock, hence avoiding holding up too much inventory, leading to increased holding costs and increased risks of theft. Capital budgeting decisions for organizations considering implementing the injections in their treatment plan should include an analysis of the costs and benefits associated with acquiring the necessities. This means that a cost benefit analysis should be carried out especially in cases where health care facilities have to put up psychiatry units that were initially not in place.
Human Resource Budget
The human resource will not vary much from the already existing wages of $16,000. However, the hospital will incur training costs associated with the introduction of the drug to its pharmacy. These costs relate to training employees on the components of the drugs, the variety available, its benefits, side effects, and the case scenarios in which its use would be applicable. Training will also detail the expected implications of incorporating the drug into the treatment process and the hospital's mission and vision in terms of providing affordable and quality health care to patients. Specialization will be required in administering the drugs to patients hence the need for training. A hospital facility that does not have a psychiatry unit in place will need to hire more personnel and train the new staff on the goals and objectives of the psychiatry units. When budgeting for capital resources, it becomes necessary for health care facilities to budget for recruitment and training of new and existing employees.
Why Long-Acting Psychotropic Injectables Should be given the Green Light.
The drugs' clinical benefit is in its' ability to reduce schizophrenia and schizoaffective disorder symptoms such as insomnia, delusions, hallucinations, anxiety, and pain. Based on the standard aim of any treatment process of attaining specific clinical outcomes and ensuring that the disease is eliminated, these drugs play a role in the treatment process. In as much as they do not treat the disease, the drugs act as supplementary drugs that support other treatment methods to reduce pain from patients hence improving the quality of the treatment they receive. For example, in drug addicts, these drugs have been found to help reduce anxiety and reduce the adverse effects of drug addiction, including reducing withdrawal symptoms and improving social behavior in patients.
Other than reducing symptoms in patients with schizophrenia and schizoaffective disorder but are also useful for patients with mild depression and bipolar disorder ( Brissos, Veguilla, Taylor & Balanzá-Martinez, 2016) . The drug hence plays a role in supporting the treatment of various psychiatry disorders. One significant advantage of these drugs is that it can be used in combination with others to t reat underlying conditions, mood stabilizers, and anti-depressants ( Jann & Penzak, 2018) . Besides, the drug virtually ensures that psychiatry disorder symptoms are managed and prevents the relapse of symptoms, leading to increased medication costs every time a patient is hospitalized.
The medication is advantageous because it helps ensure patient-centered care by administering specific care and drugs for particular clients, depending on their needs. The injections are given to the patient over two to four weeks and can be adjusted accordingly to meet the patient's needs. For example, in emergencies, severe cases, or relapses, higher dosages can be given and then reduced as the patient recovers. The fact that these drugs support various psychiatry disorders through managing the symptoms implies that their sale and use should be given the green light for use in multiple situations to attain desired clinical conditions.
Long-acting psychotropic injectables have played a significant role in supporting treatment for patients with psychiatric conditions by relieving them from the symptoms. These drugs have been influential in treating disorders such as schizoaffective disorder, mania with psychosis, and schizophrenia and have also been useful for patients with mild depression symptoms. The drugs not only cure these conditions but play a role in the treatment process by providing relief to patients. The analysis of the pros and cons indicates that both health care facilities and pharmaceuticals should consider the implementation of these drugs in the treatment process.
LAI psychotropic injections are beneficial from a social point of view. The use of these drugs on patients not only reduces suffering and pain but also plays a role in increasing family support to the patient through improved life. As such, the use LAI psychotropic injection is beneficial to both the patient, the family, the society and the health care facility at large. When physiatry patients are fine, then family members find it easier to take care of them and get and an opportunity to contribute positively to the economy of the country hence allowing them to financuaially support the family and the patient. Reduced relapse instances for these patients means more peace and happiness for the family and the patient.
References
Brissos, S., Veguilla, M. R., Taylor, D., & Balanzá-Martinez, V. (2016). The role of long-acting
injectable antipsychotics in schizophrenia: a critical appraisal. Therapeutic Advances in Psychopharmacology , 4 (5), 198–219. https://doi.org/10.1177/2045125314540297
Citrome, L . (2015). New second-generation long-acting injectable antipsychotics for the
treatment of schizophrenia . Expert Rev Neurother . 13(7):767-83. DOI: 10.1586/14737175.2013.811984 ..
Cusimano, J., & VandenBerg, A. (2020). Long-acting injectable antipsychotics and their use in
Court-ordered treatment: A cross-sectional survey of psychiatric pharmacists' perceptions. The Mental Health Clinician , 10 (1), 18–24. https://doi.org/10.9740/mhc.2020.01.018
Jann, W, Penzak, R . (2018). Long-Acting Injectable Second-Generation Antipsychotics: An
Update and Comparison between Agents. CNS Drugs. 32(3):241-257.
Schreiner A, Bergmans P, Cherubin P, Keim & Llorca P-M, Cosar B (2015). Paliperidone
palmitate in non-acute patients with schizophrenia previously unsuccessfully treated with risperidone long-acting therapy or frequently used conventional depot antipsychotics. Psychopharmacol . 29(8):910-22. DOI: 10.1177/0269881115586284 .
