Centralization impact and cost-saving study in a Moroccan hospital’s centralized unit of chemotherapy preparation

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Objective The purpose of our study was to evaluate the contribution of an automated drug dispensing system in securing cancer chemotherapy production process at the pharmacy of the National Institute of Oncology in Rabat. Methods The failure modes and effects analysis method was applied to the chemotherapy production process in two phases: Phase 1, using an open shelf for storage then phase 2, using an automated drug dispensing system. The failure modes were defined and their criticality indexes was calculated on the basis of the likelihood of occurrence, the potential severity for the patients and/or the impact on the process and the detection probability. The criticality indexes of the two phases were prioritized and compared. Results We identified 35 failure modes for phase 1 and 37 for phase 2. The sum of criticality indexes was 5957 and 4586, respectively, for phase 1 and phase 2, corresponding to a criticality reduction of −23%. The greatest improvements concerned that the needed drug is missing during the picking, storage of potential expired drugs, and double compounding. Conclusion Our study highlighted the contribution of automated drug dispensing system in risk minimization. The use of automated drug dispensing system is a part of security improvement in chemotherapy production unit.

“…On an average, 3000 cytotoxic preparations were made per month in the CCPU. 14 The risk analysis concerned the chemotherapy production step in the chemotherapy process.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk reduction in a cancer chemotherapy production unit: Contribution of an automated drug dispensing system

Ouedraogo

Baraka

Adade

et al. 2020

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“…This study assessed the practice of centralization and did not take into account the possibility of extending the microbiological stability of anticancer drugs. 15 The amount of drugs wasted accounted for an enormous burden on the annual drug budget. This situation demanded for ways to minimize anticancer drug waste in order to optimize the use of resources.…”

Section: Introductionmentioning

confidence: 99%

Anticancer drug waste minimization and cost-saving study by using a closed-system transfer device for chemotherapy compounding

Adade

Diop

Attjioui

et al. 2021

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Introduction There is a need for an economic evaluation of the use of closed system (CSTD) in chemotherapy compounding, especially in resource-constrained settings. Objective The objective of this study was to assess the cost saving of the management of cancer drug leftovers before and after introduction of CSTD associated with an extension of the beyond-use date (BUD) of cancer vials. A secondary objective was to estimate the level of minimization of drug wastage. Materials and methods This was a prospective, single-center study with two periods of two months each. The cost of drugs saved by using conventional systems (syringe and needle) without a closed system in the first period was compared to the cost of drugs saved by using the CSTD Chemoclave® system in the second period. The drug waste minimization rate compared actual drug waste to potential waste in Period 2. Results In Period 1, the amount of drug saved accounted for an average of 10.3% of the amount used in milligrams and the amount of drug wasted accounted for an average of 18.7%. In period 2, these proportions were 15.2% and 6.4% respectively. The CSTD generated an extra cost of 11,962.5 USD compared to the conventional system. The drug saved cost related only to the CSTD and the acquisition cost of the CSTD was a deficit of -7,444.95 USD and the cost saved from the compounding (CSTD and syringes) was a gain of 1,722.01 USD. The waste minimization represented an average of 72.5% ± 24.4% of potential waste. Conclusion The use of CSTD to extend the BUD allowed to reduce waste due to microbiological instability without adding an economic profit.

“…As a leader in its disciplines, NIO has a pharmacy with a Central Chemotherapy Preparation Unit (CCPU). This unit guaranteed adequate conditions for storage and preparation of cytotoxic molecules, 9 according to good manufacturing practices and French hospital preparation standards, 10 as it has been shown providing economic and therapeutic benefits. 11,12…”

Section: Introductionmentioning

confidence: 99%

“…7,8 As a leader in its disciplines, NIO has a pharmacy with a Central Chemotherapy Preparation Unit (CCPU). This unit guaranteed adequate conditions for storage and preparation of cytotoxic molecules, 9 according to good manufacturing practices and French hospital preparation standards, 10 as it has been shown providing economic and therapeutic benefits. 11,12 The huge costs of chemotherapy, 13 improving patient safety and better medication management process motivated NIO to invest in ADS technology as known to generate cost benefit, 14 improving safety and medical management process.…”

Section: Introductionmentioning

confidence: 99%

Economic impact of implementation of an automated drug supplying and management system in a Central Chemotherapy Preparation Unit in a Moroccan hospital

Baraka

Ouedraogo

Sessouma

et al. 2021

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Objective Automated Drug Supplying and management System (ADS) are effective devices that secure drug’s circuit and reduce hospital’s expenses. The purposes of this study are to estimate the earnings made from ADS through a cost-benefit medical economic study, to highlight its impact on Central Chemotherapy Preparation Unit’s (CCPU) global organization, its ergonomy and staff’s satisfaction. Method Measurement of cytotoxic drug’s consumption, expiration losses, pharmacy staff’s working time, drugs stock-out before and after the implementation of ADS on the one hand, and assess its ergonomy and acceptability by users on the other hand. Results After the implementation of ADS, cytotoxic drug’s consumption decreased by 9 (%), expiration losses by 98.3 (%), and we could see a gain in working time among CCPU’S technicians of 1.32 (h/day) and pharmacist of 0.67 (h/day), in contrast to the stock manager who increased his working time by 0.95 (h/day). Stock-out have decreased by 41.1 (%). The cost-benefit analysis has shown a net benefit of 67,437 between the two six-month phases, which corresponds to an economy of 134,874 (USD) over one year. The ADS was generally appreciated by the CCPU and pharmaceutical staff and 93(%) don’t want to return to the old system. Conclusion ADS implementation within CCPU led to financial savings in the hospital, an optimization of expenses and better pharmaceutical management.