title: [Pertinence of Off-label Prescriptions of Innovating and Expensive Drugs in a University Hospital].
abstract: OBJECTIVE
  Pertinence of off-label prescriptions of innovative and expensive drugs needs a strict scientific appraisal to prevent adverse reaction risks and financial drift.
  
  
  METHODS
  Pertinence of such prescriptions has been analyzed in a University Hospital by bibliometric methods. Scientific publications issued from this clinical activity have been also evaluated.
  
  
  RESULTS
  Oncology differed from other clinical specialties by a better pertinence in justifying off-label prescriptions (good evidence level in 46% vs. 21%, scientific publications issued from A/B ranked journals: 51% versus 41%). Quality of scientific production from oncologists was also better (publication impact factor [IF] mean: 4.571 versus 2.245).
  
  
  CONCLUSIONS
  The better pertinence of off-label prescriptions by oncologists in comparison to others clinicians' ones was mainly due to a shorter field of indications but also to a more efficient organisation such as systematic prescription by seniors, dedicated computerized provider order entry, multidisciplinary team meetings and collaborative culture.
authors.affiliation: Comité de Sécurisation des Produits de Santé (COSEPS), Assistance Publique-Hopitaux de Marseille, Marseille, France.
authors.forename: Amélie
authors.initials: A
authors.lastname: Falabregues
authors.affiliation: Comité de Sécurisation des Produits de Santé (COSEPS), Assistance Publique-Hopitaux de Marseille, Marseille, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Daul
authors.affiliation: Pôle Pharmacie, Unité Oncopharma, Assistance Publique-Hopitaux de Marseille, Marseille, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Pourroy
authors.affiliation: Pôle Pharmacie, Unité Oncopharma, Assistance Publique-Hopitaux de Marseille, Marseille, France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Gauthier-Villano
authors.affiliation: Pôle Pharmacie, Unité Oncopharma, Assistance Publique-Hopitaux de Marseille, Marseille, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Pisano
authors.affiliation: Service Central de la Qualité et de l'Information Pharmaceutique (SCQIP), Assistance Publique-Hopitaux de Marseille, Marseille, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Rathelot
authors.affiliation: Comité de Sécurisation des Produits de Santé (COSEPS), Assistance Publique-Hopitaux de Marseille, Marseille, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Vialettes
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000188:drug therapy; D016527:Drug Costs; D004363:Drug Utilization; D015507:Drugs, Investigational / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D005602:France; D006748:Hospital Departments / Q000191:economics / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007249:Inflammation / Q000188:drug therapy; D008495:Medical Oncology; D009369:Neoplasms / Q000188:drug therapy; D009422:Nervous System Diseases / Q000188:drug therapy; D056687:Off-Label Use / Q000706:statistics & numerical data*; D035583:Rare Diseases / Q000188:drug therapy; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D015507:Drugs, Investigational; D007166:Immunosuppressive Agents