An economic evaluation of vial sharing of expensive drugs in automated compounding

Baan, Simone D.; Geersing, T H; Crul, Mirjam; Franssen, Eric J. F.; Klous, M.G.

doi:10.1007/s11096-022-01388-6

Cited by 7 publications

(3 citation statements)

References 25 publications

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“…Dal punto di vista economico le poche evidenze disponibili indicano come l'adozione del sistema robotizzato potrebbe portare ad una riduzione dei costi laddove però il volume delle preparazioni annue sia elevato. Accorgimenti come la condivisione di farmaci costosi durante la preparazione robotizzata può prevenire lo spreco, con un notevole vantaggio economico e ambientale, 35,36 senza riscontrare problemi di sicurezza tipici delle tradizionali strategie di condivisione. 37 L'adozione della tecnologia automatizzata ha ridotto il tempo di preparazione e di consegna alle unità operative diminuendo di conseguenza le spese.…”

Section: Economicitàunclassified

Un sistema robotizzato per le preparazioni chemioterapiche: una revisione della letteratura

Laus

2023

Scenario

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Introduzione: la fase più critica del processo di allestimento dei chemioterapici è la preparazione, in cui si registra sia il massimo livello di esposizione per l’operatore che il maggior numero di possibili errori. Oggi sono disponibili sistemi robotizzati che possono replicare quello che l’operatore esegue manualmente. Materiali e Metodi: è stata eseguita una revisione della letteratura tra Ottobre e Novembre 2022, consultando le banche dati Medline (interfaccia PubMed), Cochrane Library e Google Scholar. I limiti applicati per la ricerca degli articoli sono stati: lingua italiana/inglese e pubblicazione negli ultimi 10 anni. Il quesito a cui si è cercato di rispondere è stato “Qual è l’efficacia, la sicurezza, l’impatto organizzativo ed economico del sistema robotizzato rispetto al sistema manuale?”. Risultati: la ricerca bibliografica iniziale ha permesso di identificare 137 articoli rilevanti per la revisione, in seguito esclusi 12 perchè duplicati, 29 perchè in lingua francese/portoghese/spagnolo e antecedenti a Ottobre 2012, 69 articoli perchè contenenti obiettivi diversi. Sono stati dunque considerati ai fini della presente revisione 27 articoli. Discussione: i dati raccolti dimostrano come l’efficacia, l’accuratezza e la precisione delle preparazioni di chemioterapici fornite tramite l’utilizzo dei sistemi robotizzati siano maggiori rispetto le preparazioni manuali. Il sistema robotizzato assicura maggiore sicurezza agli operatori e pazienti. Il confronto dei due metodi di preparazione ha evidenziato che la contaminazione delle preparazioni è inferiore nei sistemi robotizzati. Contrastanti sono i risultati sul miglioramento del workflow. Dal punto di vista economico potrebbe portare ad una riduzione dei costi. Conclusioni: al fine di poter supportare decisioni relative all’introduzione di sistemi robotizzati per la preparazione dei chemioterapici in tutti i contesti sarebbero molto utili e auspicabili ulteriori studi di confronto, soprattutto nel contesto italiano.

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Section: Economicitàunclassified

Un sistema robotizzato per le preparazioni chemioterapiche: una revisione della letteratura

Laus

2023

Scenario

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“…As for pharmacists, their role is of particular importance at the drug-compounding stage. Indeed, drugs could be discarded if vials are packed in a single size that is different from the prescribed dose based on the patient’s weight [ 20 ]. In addition, once the vials are opened, they must be administered or discarded [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Vial Sharing of High-Cost Drugs to Decrease Leftovers and Costs: A Retrospective Observational Study on Patisiran Administration in Bologna, Italy

et al. 2023

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Waste of high-cost medicines, such as orphan drugs, is a major problem in healthcare, which leads to excessive costs for treatments. The main objective of this study was to evaluate the impact of a vial-sharing strategy for patisiran, an orphan drug used for the treatment of hereditary transthyretin-mediated amyloidosis, in terms of a reduction in the discarded drug amount and cost savings. The retrospective observational study was conducted in a tertiary referral center (Emilia-Romagna, Italy), between February 2021 and November 2022. Data on drug waste were calculated as “(mg used–mg prescribed)/mg prescribed” for each session. We found a statistically significant (−9.14%, p < 0.001, 95% CI 5.87–12.41) absolute difference in mean discarded drug rates per session based on the study phase (before and after vial-sharing introduction) at the two-sample t-test. The absolute difference corresponded to a percentage decrease in the average reduction in the discarded drug rate with vial sharing of 82.96% per session. On an annual scale, the estimated cost savings was EUR 26,203.80/year for a patient with a standard body weight of 70 kg. In conclusion, we demonstrated that a patisiran vial-sharing program undoubtedly offsets some of the high costs associated with this treatment. We suggest that this easy-to-introduce and cost-effective approach can be applied to the administration of other high-cost drugs.

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“…Vial sharing has become common in large hospitals, especially for expensive drugs. 8,9 By using quantities of drugs that would have previously been discarded, cytotoxic and biological waste production is also reduced. A study retrospectively analyzed the wastage of cancer chemotherapeutic drugs in an oncology unit and found that vial sharing showed a 9% reduction in 1 year.…”

Section: Introductionmentioning

confidence: 99%

Combining the Real-Time Vial Sharing Strategy with Daily-Rate Charge Mode for Antimicrobial Drugs of Inpatients: An Economical and Practical Method for Patients and Hospitals

Li¹,

He²,

Liu³

et al. 2023

RMHP

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Background: Antimicrobial agents' wastage is a huge problem, especially for pediatric patients, resulting in excessive drug expenditure and increasing the economic burden on patients' families. Moreover, the cost of disposing of antimicrobial agents' waste and the risk of environmental and occupational exposure also increased. This study aimed to explore the cost-effectiveness of the vial-sharing strategy combined with the daily-rate charge mode for pediatric inpatients to provide a strategy for reducing patients' expenditures, saving medical costs, and reducing drug proportion. Methods: This retrospective study was conducted at Pharmacy Intravenous Admixture Service (PIVAS), Shenzhen Children's Hospital, Guangdong Province, China, in 2022. Data on prescription drugs were collected from the PIVAS system. Ten antimicrobial drugs with a frequency of prescriptions no less than twice once daily were selected, and the drug costs, drug weight, and drug saved were further analyzed according to the combination of real-time vial sharing strategy and daily-rate charge mode. Traditional single vial charge mode without vial sharing was set as a control strategy. The actual expenditure of the hospital was also calculated and analyzed. Results: During 2022, ¥ 4,122,099 (34.4%) was saved for inpatients by applying a vial-sharing strategy on ten antibacterial agents, and more than 46,343,750 mg (24.6%) of drugs were totally saved. The top 5 drugs saved by the real-time vial-sharing strategy were cefoperazone-sulbactam, vancomycin, amoxicillin-sulbactam, ceftazidime, and meropenem. Taken the price into consideration, the top five payment-saved drugs were vancomycin (¥ 1,522,385), meropenem (¥ 1,311,475), cefoperazone-sulbactam (¥ 736,697), imipenemcilastatin (¥ 406,092), and amoxicillin-sulbactam (¥ 51,394). Moreover, the account balance of the hospital was up to ¥ 426,499. Conclusion:The real-time vial sharing strategy combined with the daily-rate charge mode greatly reduces drug wastage and patients' payments. It may be useful for hospitals with PIVAS to achieve vial-sharing while protecting the best interest of inpatients.

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An economic evaluation of vial sharing of expensive drugs in automated compounding

Cited by 7 publications

References 25 publications

Un sistema robotizzato per le preparazioni chemioterapiche: una revisione della letteratura

Un sistema robotizzato per le preparazioni chemioterapiche: una revisione della letteratura

Vial Sharing of High-Cost Drugs to Decrease Leftovers and Costs: A Retrospective Observational Study on Patisiran Administration in Bologna, Italy

Combining the Real-Time Vial Sharing Strategy with Daily-Rate Charge Mode for Antimicrobial Drugs of Inpatients: An Economical and Practical Method for Patients and Hospitals

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