Background National Guide of Good Preparation Practice for Medicinal Products in Hospital Pharmacy Departments (HPD) (2014) recommends the use of a risk matrix (RM) to assess the risks during the preparation and ensure the quality of the finished product. The RM evaluates several topics: preparation process, administration route, safety profile, number of preparations per batch and microbiological contamination susceptibility.
According to the level of risk assigned by the RM, storing conditions and expiry dates for each preparation may change from labelled information and extended stability studies. Thus, in most cases, after implementing a RM in the preparation of medication at the HPD, there is a shorter in-use expiry date both for the final product and for the vial leftovers. Shorter expiry dates could lead to a greater waste of product, and therefore, greater economic losses.
Purpose We aim to evaluate the economic impact in the preparation of chemotherapy after implementing the RM in our pharmacy.
Material and methods Prospective observational study.
Two phases: pre-implementation (1 month) and post-implementation (1 month) of the RM.
All preparations of parenteral antineoplastic drugs in the HPD were included in the analysis.
Standard local protocols for preparation and storing of remaining starting material (vials) were followed in both phases.
All remaining vials that exceeded the expiry date were stored separately and the amount of product within was measured. Finally, the cost for all discarded products was calculated in each phase and compared.
Results Expiry dates were reduced in only six drugs (9%) after modifying stability according to the RM.
The number of preparations in the anti-neoplastic preparation unit was 1479 in the pre-implementation phase and 1434 in the post-implementation phase.
Previous to the implementation of the RM, 1.01% of the cost of drugs prepared in the HPD was due to discarded product after storing dates were exceeded. After the implementation of the RM, this was 0.97%.
Conclusion The implementation of a risk matrix in the preparation of parenteral anti-neoplastics has no significant economic impact in terms of discarded product.
References and/or acknowledgements No conflict of interest.
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