Background and importance The rise of promising new cancer therapies and their costs represents a colossal challenge for health systems. In addition, we face daily restrictions on the supply of cytotoxic drugs, while the number of patients is increasing. The Cytotoxic Centralised Units (CCUs) allow the optimiwed use of cytotoxics and monoclonal antibodies vials between treatments. There is, however, a significant waste of drugs, due to the impossibility to reuse the vials if they lose the sterility conditions provided by the biosafety chamber, at the end of the working day. Closed system transfer devices (CSTDs) were initially developed to minimise occupational exposure during cytotoxic preparation. They represent an important additional resource providing safety for the technician and facilitating work operations in the chamber. Recent data supporting the extent of the physical and chemical stability of drugs and the sterility provided by the CSTD in an aseptic environment allow the remaining amounts of each vial to be stored and reused.
Aim and objectives Assess the profitability of the use of CSTDs in the CCU.
Material and methods Several models of CSTDs were analysed concerning their safety performance and ergonomic design. The Tevadaptor model was the one selected. During 2020, the daily records of wastes and savings of each oncologic drug vial were compared, as well as the comparison between the saving on opening new vials versus the annual cost for the acquisition of the CSTDs.
Results The increase in the annual budget reached the amount of €14 934. The analysis of the number of vials that were spared with the reuse of the waste of each day resulted in a total annual savings of €205 665.05. The balance is clearly positive for the institution, with an economic outcome of €190 731.
Conclusion and relevance The innovation cost in oncology, combined with a context of frequent shortages, offers constant challenges to hospital budgets and makes it imperative to reduce daily waste with drugs. The use of CSTDs is a strategy that entails additional costs but allows maximisation of the use of the vial, always respecting the physical-chemical and microbiological stability of each drug, offering additional security in the working area and decreasing the risk of occupational exposure.
Conflict of interest No conflict of interest
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