Chan Huan Keat, Lim Yik Ming
Clinical Research Center, Sultanah Bahiyah Hospital, Alor Setar, Malaysia.Email:
Asian Pac J Cancer Prev. 2016 Nov 1;17(11):4951-4957. doi: 10.22034/APJCP.2016.17.11.4951.
Background: Apart from reducing occupational exposure to cytotoxic hazards, the PhaSeal® closed-system transfer device (CSTD) can extend the beyond-use dates (BUDs) of unfinished vials of antineoplastic drugs for up to 168 hours (seven days). In this study, the total material cost incurred by its use in a Malaysian government-funded hospital was calculated. Methods: A list of vial stability following initial needle punctures of 29 commonly-used antineoplastic drugs was compiled. The amount of the materials used, including drugs, infusion bottles, the PhaSeal® CSTD and other consumables, was recorded on a daily basis for three months in 2015. The total cost was calculated based on the actual acquisition costs, and was compared with that of a hypothetical scenario, whereby conventional syringe-needle sets were used for the same amounts of preparations. Results: The use of the PhaSeal® CSTD incurred a cost of MYR 383,634.52 (USD 92,072.28) in three months, representing an average of MYR 170.5 (USD 40.92) per preparation or an estimated annual cost of MYR 1,534,538.08 (USD 368,289.14). Compared with conventional syringe-needle approach, it is estimated to lead to an additional spending of MYR 148,627.68 (USD 35,670.64) yearly. Conclusion: Although there was a reduction of drug wastage achieved by extending BUDs of unfinished vials using the PhaSeal® CSTD, cost saving was not observed, likely attributable to the wide use of lower-priced generic drugs in Malaysia. Future studies should further evaluate the possibility of cost saving, especially in health settings where branded and high-cost antineoplastic drugs are more commonly used.
除了减少职业暴露于细胞毒性危害外，PhaSeal® 密闭系统转移装置（CSTD）还可将未使用完的抗肿瘤药物小瓶的使用期限（BUDs）延长至168小时（七天）。在本研究中，计算了其在一家马来西亚政府资助医院使用所产生的总材料成本。方法：编制了29种常用抗肿瘤药物初次针刺后的小瓶稳定性清单。2015年，每天记录使用的材料数量，包括药物、输液瓶、PhaSeal® CSTD和其他耗材。总成本根据实际采购成本计算，并与假设情景进行比较，即使用传统注射器针头套装进行相同数量的制剂配制。结果：使用PhaSeal® CSTD在三个月内产生的成本为383,634.52马来西亚林吉特（92,072.28美元），平均每次制剂成本为170.5马来西亚林吉特（40.92美元），估计年度成本为1,534,538.08马来西亚林吉特（368,289.14美元）。与传统注射器针头方法相比，估计每年会导致额外支出148,627.68马来西亚林吉特（35,670.64美元）。结论：虽然使用PhaSeal® CSTD延长未使用完小瓶的使用期限可减少药物浪费，但未观察到成本节约，这可能归因于马来西亚广泛使用低价仿制药。未来的研究应进一步评估成本节约的可能性，特别是在更常用品牌和高成本抗肿瘤药物的医疗机构中。
