Evaluation of a clinic-based quality structure for Special Access Programme medicines to treat parasitic infections

Background: Frequently used drugs in our unit are only available through Health Canada’s Special Access Programme (SAP) or a compounding pharmacy. A tracking system was implemented to evaluate the turnaround time (TAT) and success rate of SAP applications for parasitic infections. Methods: We undertook a retrospective review of SAP logs from 2013 to 2015 inclusive, with outcomes of TAT and initial application success rates over time. Analyses were stratified by drug indication. Results: The mean TATs for all indications from 2013 to 2015 were 9.02 (SD 10.11) days, 7.04 (SD 7.6) days, and 7.25 (SD 8.97) days, respectively (p = 0.48). First-time success rates for ivermectin from 2013 to 2015 were 96%, 84%, and 71%, respectively. First-time success rates for albendazole from 2013 to 2015 were 74%, 60%, and 63%, respectively. In 2013, 14% (6/44) of initial SAP requests received an incomplete notification compared with 25% (14/57) and 32% (25/78) in 2014 and 2015, respectively (p = 0.08). Conclusions: Timely initiation of antihelminthic therapy is critical to reducing the risk of adverse clinical outcomes and a decreased quality of life from parasitic infections such as strongyloidiasis. Our findings document a prolonged TAT of non-formulary medications used to treat common helminthiases in Canada.