Background Antineoplastic drugs are considered ‘high-risk drugs’ due to the increased frequency of human technical errors in their preparation. It is essential for pharmacists to be responsible for setting up, centralising and managing cytotoxic drugs (CDs). To this end, the Division of Anticancer Drugs of L’Aquila (Italy) acquired on June 2012 a Robotic System, APOTECAchemo, the first worldwide system for chemotherapy compounding in a controlled atmosphere.
Purpose To analyse the impact of centralising and automating CD preparation for all the Departments in the Hospital of L’Aquila, to avoid any possibility of human error and to optimise the use of the remainder of CDs.
Materials and Methods Three high cost monoclonal antibodies (bevacizumab, cetuximab and trastuzumab) were chosen for analysis in this study during the period June–September 2012. The criteria for product suitability were evaluated by analysing the APOTECAchemo database in which all stages of the production process are recorded (picture of the bottle used, weight, and dose accuracy). The cost analysis was evaluated by calculating the daily amounts left over of the three drugs that were previously discarded and are now fully re-used.
Results The average error was for 168 preparations of bevacizumab + 0.45% (DS = 1.85), for 67 preparations of cetuximab + 0.71% (DS = 1.13) and for 152 preparations of trastuzumab −0.57% (DS = 1.8).
In the period under review, 85.9 g of bevacizumab, 37.5 g of cetuximab and 43.8 g trastuzumab were prepared using material that would previously have been discarded. This provided considerable saving for the three drugs (€29,893) which corresponds to approximately €90,000 per year.
Conclusions The centralised system and the use of APOTECAchemo is successful both in terms of patient and operator safety and cost benefit for the Hospital.
No conflict of interest.
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