Background Botulinum toxin (BT) is a neurotoxin produced by C. botulinum that blocks the release of acetylcholine at peripheral cholinergic nerve endings.
Purpose To evaluate the profile of BT use in our hospital, as well as the savings due to the manufacture of pre-filled syringes in the Pharmacy Department.
Material and methods Retrospective study (Jan–Dec 2013). Data collected: IU consumed of BT, doses, Medical Department, number of patients, indication and cost. Vials of BT (100 IU) were reconstituted with sterile saline 0.9% (in a Horizontal Laminar Flow cabinet). The reconstituted solution was stable for 4–24 h at 2–8°C.1,2 After reconstitution pre-filled syringes were prepared and conditioned with the exact doses requested. After processing, the remaining material was discarded in an appropriate container.
Results BT manufactured (IU): 11,615, 259 patients (682 doses). Consumption/ Medical Department, Pain Unit: 4,208 IU, General Surgery: 3,074 IU, Rehabilitation: 1,900 IU, others: 2,433 IU. Doses more frequently used were 7 IU/0.21 mL by General Surgery (392), 75 IU/2 mL and 100 IU/2 mL by Pain Unit (31 units and 19 units, respectively) and 5 IU/0.15 mL by Ophthalmology (48). The main ward using pre-filled syringes was General Surgery (400), followed by Ophthalmology (135), Pain Unit (75), others (72). The cost of BT was €28,482.5. 80% of BT was used in blepharospasm and focal spasticity. The manufacture of pre-filled syringes in the Pharmacy Department represented a saving of 81 vials. We estimate a potential saving/year (direct cost) of €12,729.6 (-45%).
Conclusion The Pain Unit and Surgery General presented the higher consumption of BT. The manufacture of pre-filled syringes by the Pharmacy Department allowed us to optimise the consumption of this drug, achieve considerable cost savings as well as ensure the sterility of the process.
ReferencesNo conflict of interest.
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