Bourget P, Amin A, Vidal F, Merlette C, Troude P, Corriol O
J Pharm Belg. 2013 Sep(3):32-45.
In France, central IV admixture of chemotherapy (CT) treatments at the hospital is now required by law. We have previously shown that the shaping of Therapeutic Objects (TOs) could profit from an Analytical Quality Assurance (AQA), closely linked to the batch release, for the three key parameters: identity, purity, and initial concentration of the compound of interest. In the course of recent and diversified works, we showed the technical superiority of non-intrusive Raman Spectroscopy (RS) vs. any other analytical option and, especially for both HPLC and vibrational method using a UV/visible-FTIR coupling. An interconnected qualitative and economic assessment strongly helps to enrich these relevant works. The study compares in operational situation, the performance of three analytical methods used for the AQC of TOs. We used: a) a set of evaluation criteria, b) the depreciation tables of the machinery, c) the cost of disposables, d) the weight of equipment and technical installations, e) the basic accounting unit (unit of work) and its composite costs (Euros), which vary according to the technical options, the weight of both human resources and disposables; finally, different combinations are described. So, the unit of work can take 12 different values between 1 and 5.5 Euros, and we provide various recommendations. A qualitative evaluation grid constantly places the SR technology as superior or equal to the 2 other techniques currently available. Our results demonstrated: a) the major interest of the non-intrusive AQC performed by RS, especially when it is not possible to analyze a TO with existing methods e.g. elastomeric portable pumps, and b) the high potential for this technique to be a strong contributor to the security of the medication circuit, and to fight the iatrogenic effects of drugs especially in the hospital. It also contributes to the protection of all actors in healthcare and of their working environment.
在法国,法律现已规定医院必须进行化疗(CT)治疗的中心静脉药物混合配置。我们之前已经表明,对于治疗对象(TOs)的成型而言,与批次放行紧密相关的分析质量保证(AQA)可用于三个关键参数:目标化合物的身份、纯度和初始浓度。在近期多样的工作过程中,我们展示了非侵入式拉曼光谱(RS)相对于任何其他分析方法的技术优势,特别是与使用紫外/可见 - 傅里叶变换红外光谱耦合的高效液相色谱法(HPLC)和振动方法相比。相互关联的定性和经济评估有力地有助于丰富这些相关工作。该研究在实际操作情况下比较了用于治疗对象分析质量控制(AQC)的三种分析方法的性能。我们使用了:a)一组评估标准,b)机器折旧表,c)一次性用品成本,d)设备和技术装置的重量,e)基本核算单位(工作单元)及其综合成本(欧元),这些会因技术选项、人力资源和一次性用品的重量而有所不同;最后描述了不同的组合。因此,工作单元的成本在1至5.5欧元之间可有12种不同取值,并且我们提供了各种建议。一个定性评估网格始终将拉曼光谱技术置于优于或等同于目前可用的其他两种技术的位置。我们的结果表明:a)由拉曼光谱进行的非侵入式分析质量控制具有重大意义,特别是在无法用现有方法(如弹性体便携式泵)分析治疗对象时;b)该技术在保障药物回路安全以及对抗药物医源性影响方面具有巨大潜力,尤其是在医院环境中。它还有助于保护医疗保健领域的所有参与者及其工作环境。