Automated drug dispensing systems in the intensive care unit: a financial analysis

Abstract

IntroductionTo evaluate the economic impact of automated-drug dispensing systems (ADS) in surgical intensive care units (ICUs). A financial analysis was conducted in three adult ICUs of one university hospital, where ADS were implemented, one in each unit, to replace the traditional floor stock system.MethodCosts were estimated before and after implementation of the ADS on the basis of floor stock inventories, expired drugs, and time spent by nurses and pharmacy technicians on medication-related work activities. A financial analysis was conducted that included operating cash flows, investment cash flows, global cash flow and net present value.ResultsAfter ADS implementation, nurses spent less time on medication-related activities with an average of 14.7 hours saved per day/33 beds. Pharmacy technicians spent more time on floor-stock activities with an average of 3.5 additional hours per day across the three ICUs. The cost of drug storage was reduced by €44,298 and the cost of expired drugs was reduced by €14,772 per year across the three ICUs. Five years after the initial investment, the global cash flow was €148,229 and the net present value of the project was positive by €510,404.ConclusionThe financial modeling of the ADS implementation in three ICUs showed a high return on investment for the hospital. Medication-related costs and nursing time dedicated to medications are reduced with ADS.

Economic Evaluation of the Deployment of Electronic Dispenser in Intensive Care Uni

“…13 Chapuis et al Demonstrated a reduction of approximately 50% in the quantity of drugs in stock in an ICU and 47.22% in the stock value after implantation of an electronic dispensary. 7 At the ICU investigated, medication returns decreased in quantity (88.20%), whereas for PPS, there was an increase of 3,811.11% (table 2), which may be related to the stock without the necessary control before deployment. With the electronic dispensary, there is a return stimulus per patient (especially related to PPS) and a decrease of returns per unit (not recommended).…”

“…10,13 Its benefits have been measured and involve increased safety, 13,14 the dispensing efficiency of the medicinal products, 13 in addition to more accurate inventories and increased traceability in drug use and access. 7,13 With this, it is observed reduction of inventories, diversion of medicines and increase of the financial return. 7,13 In short, electronic dispensaries are deployed in hospital units with the expectation of increasing human resource efficiency and increasing the quality of drug distribution systems.…”

“…13 The return on investment estimated in table 4 shows that the savings generated by the decrease in consumption with the electronic dispensary and the reduction of costs with HR are able to pay off the investment in approximately 20 months -a medium period of time, a result consistent with other studies. 1,7,12 Electronic dispensaries have been studied as alternatives to the drug distribution processes in hospitals. It is a health technology not well-known in Brazil, with the potential to reduce medication errors.…”

“…5 Electronic dispensers usually have high initial investment, but studies have shown that there is financial return to the institution. 6,7 For the items to be withdrawn from the electronic dispensary, these must be linked to a prescription, which allows the reimbursement of these items by the hospital institution. The electronic dispenser ensures greater inventory control, which also reflects better financial control.…”

“…1 Other gains with the implantation of electronic dispensaries are related to the decrease in the values of inventory, greater control of the validity of the items and reduction of the time spent by the nursing with trips to the pharmacy for the withdrawal of medicines. 6,7 In addition to the economic impact, the implementation of the dispensary brings benefits related to patient safety. There are reports showing that the greater the workload of the nursing team, the greater the chances of errors occurring related to care.…”