Cost analysis of implementing a vial-sharing strategy for chemotherapy drugs using intelligent dispensing robots in a tertiary Chinese hospital in Sichuan

Abstract

IntroductionChemotherapy drug wasting is a huge problem in oncology that not only results in excessive expenses on chemotherapy drugs but also increases the cost of disposing of chemotherapy waste and the risk of occupational exposure in the environment. The main objective of this study was to evaluate the potential for hospitals in China to employ a real-time vial-sharing strategy that can save drug costs.MethodThis study was conducted retrospectively at Pharmacy Intravenous Admixture Services (PIVAS), People's Hospital of Sichuan Province, China, from September to November 2021. Data on prescription drugs wasted were collected from the Hospital Information System (HIS). To assess the real-time vial-sharing strategy, we estimated drug wastage and drug waste costs using intelligent robots that dispense multiple prescriptions simultaneously.Results24 of the 46 wasted drugs were cost-saved. The vial-sharing strategy saved 186,067 mg of drugs, or ~59.08% of the total amount wasted, resulting in savings of 150,073.53 China Yuan (CNY), or 47.51% of the cost of the total waste.ConclusionOur investigation established that employing a real-time vial-sharing strategy using an intelligent robot to dispense multiple prescriptions simultaneously is cost-effective. Additionally, this approach presented no safety issue concerns, such as the introduction of impurities to sterile compounding via repeated interspersing or the incorrect registration of information during drug storage, often encountered with traditional vial-sharing strategies.

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

“…In a recent study by Liu et al evaluating the potential for hospitals in China to employ a real-time vial-sharing strategy using a robot, this new technology was found to be of great help in saving up to ~59.08% of the total amount wasted of 24 different drugs [ 30 ].…”

Vial-splitting and Repackaging into Aliquot-specific Syringes: A Cost-effective and Waste-decreasing Strategy for Sugammadex

“… 2 Liu et al demonstrated decreased drug wastage of chemotherapeutic agents with intelligent dispensing robots and a vial-sharing strategy. 3 Sodre et al reported that when compared with standard single vial use, vial sharing for the intravitreal administration of bevacizumab resulted in a decrease in public health costs and increased the availability of the drug to public health care patients. 9 …”

“…Various studies for other medications have shown a significant benefit with vial-splitting and drug repackaging, with decreased medication costs and less waste. 2 , 3 In these cases, the pharmacy performs vial splitting and repackaging under a sterile hood to ensure patient safety. It is important to note that vials should not be empirically split inside the operating room, as this can increase the risk of contamination between patients and violates the current standard of care.…”

Statistical analysis of the storage time of finished product infusion

“…1–4 The emergence of the PIVAS has reduced the adverse reactions and patient mortality caused by contaminated and incorrectly mixed intravenous infusions and has improved work efficiency by guaranteeing clinically rational drug use and reducing the cost of drug allocation. 5–8…”

“…[1][2][3][4] The emergence of the PIVAS has reduced the adverse reactions and patient mortality caused by contaminated and incorrectly mixed intravenous infusions and has improved work efficiency by guaranteeing clinically rational drug use and reducing the cost of drug allocation. [5][6][7][8] The goal of the PIVAS is to centrally and precisely dispense finished infusions using standard operating procedures. 9 However, at present, the PIVAS's inability to reasonably use drugs is mainly focused on the review of prescriptions [10][11][12] despite the lack of standardized management of the process from configuration to delivery of medication to the patient, which results in the placement time for finished infusion solutions being overlooked.…”