Edwards Michael S, Solimando Dominic A, Grollman Franklin R, Pang Janet L, Chasick Ashley H, Hightman Charlene M, Johnson Anthony D, Mickens Maxine G, Preston Lorenzo M
Hematology-Oncology Pharmacy Service, Department of Pharmacy, Walter Reed National Military Medical Center, Bethesda, MD, USA.
J Oncol Pharm Pract. 2013 Dec;19(4):338-47. doi: 10.1177/1078155213499387. Epub 2013 Aug 23.
Medication cost is a major factor associated with increasing health care costs in the United States. Expenditures for prescription drugs in 2013 are estimated to be $283.7 billion. Closed system transfer devices are widely used for preparation of hazardous drugs. Reports indicate the Phaseal(®) closed system transfer device maintains sterility in vials for 7 days, suggesting the unused portion of single-use vials could be salvaged. This study was done to determine whether using a closed system transfer device to extend the beyond-use date of single-use vials of antineoplastic medications would result in a measurable cost saving.
A list of 25 drugs available in single-use vials, with a chemical stability of at least 48 hours, was compiled. Use of these agents was recorded during a 50-day period in April through June 2012. Use from a total of 296 vials of 21 antineoplastic agents was recorded. After allowing for the initial use of each vial, the mean potential percentage of drug waste was calculated to be 57.03%.
Actual savings during the study period was $96,348.70. The pharmacy avoided nearly half of the potential waste and saved a mean of 29% of each vial. The cost-saving during the study period represents a $703,047.67 annual saving; which more than offsets the $106,556.55 the pharmacy spent for the Phaseal(®) system in 2012.
In addition to being a protective measure to reduce exposure to hazardous agents, use of the Phaseal(®) system results in a reduction in drug waste, and a noticeable cost saving for antineoplastic agents.
药物成本是美国医疗保健成本上升的一个主要因素。2013年处方药支出估计为2837亿美元。封闭系统转移装置广泛用于危险药物的配制。报告表明，Phaseal（®）封闭系统转移装置可使小瓶保持无菌7天，这表明一次性小瓶中未使用的部分可以挽救。本研究旨在确定使用封闭系统转移装置延长一次性抗肿瘤药物小瓶的使用期限是否会带来可衡量的成本节约。
编制了一份25种可用于一次性小瓶的药物清单，其化学稳定性至少为48小时。在2012年4月至6月的50天内记录了这些药物的使用情况。记录了总共296瓶21种抗肿瘤药物的使用情况。在考虑每个小瓶的初始使用后，计算出药物浪费的平均潜在百分比为57.03%。
研究期间实际节省了96348.70美元。药房避免了近一半的潜在浪费，平均每瓶节省了29%。研究期间的成本节约相当于每年节省703047.67美元；这足以抵消药房2012年为Phaseal（®）系统花费的106556.55美元。
除了作为减少接触危险制剂的保护措施外，使用Phaseal（®）系统还可减少药物浪费，并为抗肿瘤药物节省可观的成本。
