How can the use of closed system transfer devices to facilitate sharing of drug vials be optimised to achieve maximum cost savings?

Gilbar, Peter J; Chambers, Carole; Vandenbrouche, Johan; Sessink, P.J.M.; Tyler, Timothy

doi:10.1177/1078155217753890

Cited by 15 publications

(23 citation statements)

References 29 publications

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“…Vial sharing is a drug delivery practice that deploys strategies to safely administer the leftover portion of the drug in a single-use vial to a second patient instead of discarding it. The safety of vial sharing is enhanced by technologies such as closed-system drug-transfer devices that reduce the risk of microbial contamination ( 16 ). Per the infection-control guideline of the Centers for Disease Control and Prevention, vial sharing is prohibited because the guideline requires a new syringe and needle (as in the case of single-dose vials) to be used by 1 patient ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

Financial Burden of Discarded Weight-based Antineoplastic Drugs to Payers and Patients in the Private Insurance Market

Shih

Zhao

Schrag

et al. 2021

JNCI Cancer Spectrum

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Background To estimate insurance payments and patient out-of-pocket (OOP) expenses associated with discarded weight-based intravenous anti-neoplastic drugs for privately insured US adult cancer patients. Methods We identified patients who received weight-based anti-neoplastic drugs from 2017 MarketScan Health Risk Assessment (HRA) linked to claims data. Using weight information in the HRA, we derived the recommended dose and calculated the percentage of drugs discarded. We applied beta regression to determine factors associated with the discarded percentages. To compare patients with and without high-deductible plans, we employed generalized linear model and two-part model to examine insurance payment and OOP expense, respectively. All statistical tests were 2-sided. Results Of 27,350 claims for 58 weight-based anti-neoplastic drugs from 1,970 patients, the median discarded percentage was 9.8% (mean = 12.8%, SD = 10.5%). Aside from drug and tumor type, statistically significantly higher discarded percentages were found for patients in the lowest weight group (5.5%, 95% confidence interval = 4.7% – 6.4%; P < .001, weight <150 vs. ≥200 lb). Private payers spent $5,090 per patient in 2017 on discarded weight-based anti-neoplastic drugs and patients’ mean OOP expense on discarded drugs was $63. 39.7% of patients had high-deductible plans. The adjusted mean OOP expense for discarded drugs was statistically significantly higher for those in high-deductible plans ($95 vs. $47, P < .001). Conclusions Private insurers incurred substantial financial burden from discarded weight-based anti-neoplastic drugs. Although OOP expenses of discarded drugs were modest for most privately insured cancer patients, approximately 5% spent over $400 on the discarded drugs. Policies designed to reduce drug waste from single-dose, weight-based anti-neoplastic drugs should evaluate their financial consequences for payers and patients.

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Section: Discussionmentioning

confidence: 99%

Financial Burden of Discarded Weight-based Antineoplastic Drugs to Payers and Patients in the Private Insurance Market

Shih

Zhao

Schrag

et al. 2021

JNCI Cancer Spectrum

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“…Many strategies for ensuring value for money on injectable cancer therapies have been suggested and include increasing the range of vial sizes available, dose banding, ensuring enough overage in vials and investigating better drug stability or the optimisation of the residual vial contents. Health facilities are faced with the daily predicament of what should be done with the residual contents of vials used in the preparation of sterile products by pharmacy departments.…”

Section: Discussionmentioning

confidence: 99%

Utility of PhaSeal, a closed‐system drug transfer device, in facilitating vial sharing to reduce waste and assist in medication cost savings

Siderov

2019

Pharmacy Practice and Res

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Background The cost of cancer care is rising. With the soaring costs of cancer treatment, strategies to minimise medication wastage have become more important. Aim This study evaluated cost savings associated with a centralised pharmacy aseptic service using the closed‐system drug transfer device PhaSeal (Becton, Dickinson and Company, North Ryde, NSW, Australia) for the preparation of monoclonal antibodies (mAbs) in a large teaching hospital. Methods Two scenarios for the preparation of mAb were evaluated retrospectively over a 24‐month period. All doses prepared by pharmacy in 2016 and 2017 were reviewed. In Scenario 1, costs were determined for mAb prepared by the centralised pharmacy aseptic service using PhaSeal. In Scenario 2, each individual dose was reviewed to determine the minimum number of vials that needed to be prepared, with any residual vial contents disposed of. Results In all, 8291 preparations were reviewed. The medication costs savings over the 24‐month period was A$1 259 394. The cost of PhaSeal in the preparation of the 8291 items equates to A$207 275. Conclusion Centralising aseptic preparation of mAbs together with the utilisation of PhaSeal to allow vial sharing in a large teaching hospital resulted in savings of A$526 059 per year by significantly minimising medication wastage.

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“…To facilitate this, further research should be conducted into the use of closed system transfer devices and their ability to extend the beyond use dating of single-use vials. 25 The COVID-19 pandemic has created great economic hardship for all countries. Healthcare spending has increased enormously.…”

Section: Pembrolizumabmentioning

confidence: 99%

Dosing of PD-1 and PD-L1 inhibitors: Cost saving initiatives for significantly decreasing associated expenditure

Gilbar

Davis

2020

J Oncol Pharm Pract

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How can the use of closed system transfer devices to facilitate sharing of drug vials be optimised to achieve maximum cost savings?

Cited by 15 publications

References 29 publications

Financial Burden of Discarded Weight-based Antineoplastic Drugs to Payers and Patients in the Private Insurance Market

Financial Burden of Discarded Weight-based Antineoplastic Drugs to Payers and Patients in the Private Insurance Market

Utility of PhaSeal, a closed‐system drug transfer device, in facilitating vial sharing to reduce waste and assist in medication cost savings

Dosing of PD-1 and PD-L1 inhibitors: Cost saving initiatives for significantly decreasing associated expenditure

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