Wastage of residual vial contents has the potential to significantly affect overall drug expenditure, adding costs without adding value. A centralised pharmacy aseptic service can significantly impact on wastage associated with the preparation of MABs.
To evaluate cost savings associated with a centralized pharmacy aseptic service utilizing a closed system drug transfer device (PhaSeal) for the preparation of monoclonal antibodies (MABs) used in the treatment of malignant disease in a large teaching hospital
Two scenarios for the preparation of MAB were evaluated retrospectively over a 12-month period. All doses prepared by pharmacy in 2016 were reviewed. MABs included bevacizumab, cetuximab, ipilimumab, nivolumab, panitumumab, pembrolizumab, rituximab, and trastuzumab. In scenario 1, costs were determined for MABs prepared by the centralised pharmacy aseptic service using PhaSeal to allow the residual fraction of the vial to be used continuously until the vial’s expiry.1 In scenario 2, each individual dose was reviewed to determine the minimal number of vials required to be prepared by nursing staff. The cost of each scenario was compared.
A total of 2865 preparations were reviewed. The drug costs for each scenario for the MABs investigated are:
Scenario 1 costs: $9,787,056
Scenario 2 costs: $10,107,967
The costs of PhaSeal for preparing the 2865 items equates to $57,300.
Centralising preparation of MABs using PhaSeal in a large teaching hospital resulted savings of over $263,611 per year by significantly minimising medication wastage.
This project was funded by an unrestricted education grant from Becton Dickinson