Background The growing use of expensive drugs has brought about the introduction of new strategies to optimise financial resources in hospital pharmacy. Some sterile preparations of expensive drugs are reconstituted in medical wards. Frequently, available preparations don’t match with patient doses, therefore part of the reconstituted drug is lost.
Purpose To assess the financial impact of pharmacy reconstitution of preparations for individual patients, in order to improve the drug reconstitution process.
Material and methods A prospective study was carried out in a university hospital between June 2013 and June 2014. We studied drugs reconstituted in a laminar fluid cabinet (LFC) excluding cytotoxics, biological drugs and parenteral nutrition solutions. Additionally, we reviewed the most expensive drugs reconstituted in out-patients, chosen after a pilot financial study. These drugs were reconstituted by pharmacy staff by a volumetric method of preparation instead following the manufacturer’s instructions, using the entire volume of the vial, including overfill and without discarding drug leftovers. Data collected: number of treatments, type of drugs, time of preparation and savings.
Results The most expensive drug reconstituted in outpatient wards was levosimendan. In LFCs ganciclovir and foscarnet were chosen. Total of treatments: 44, levosimendan 12 (27.27%), ganciclovir 26 (59.09%), foscarnet 6 (13.64%). Savings: €9,100.68; levosimendan: €3,629.4 (39.88%), ganciclovir €2,249 (59.09%), foscarnet: €3,221.84. Pharmacy compounding time: 5 (3–8) minutes. In terms of the technician’s annual salary, average cost per preparation was €0.75 (0.45–1.35). Total cost of technician per year: 33€. Total savings: € 9,067.68.
Conclusion Preparation by the Pharmacy staff represents an efficient strategy. The estimated annual savings were up to €9000, with only €40 of investments. The implementation of strategic cost management in the process of drug reconstitution is key to improve efficiency and profitability.
References and/or Acknowledgements No conflict of interest.
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