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Analysis of production time and capacity for manual and robotic compounding scenarios for parenteral hazardous drugs
  1. Tjerk H Geersing1,2,
  2. Demelza M Pourahmad3,
  3. Femke Lodewijk4,
  4. Eric J F Franssen5,
  5. Catherijne A J Knibbe1,2,
  6. Mirjam Crul3
  1. 1 Department of Clinical Pharmacy, St Antonius Hospital, Nieuwegein, The Netherlands
  2. 2 Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
  3. 3 Department of Clinical Pharmacology and Pharmacy, Amsterdam University Medical Center, location Vrije Universiteit, Amsterdam, The Netherlands
  4. 4 Pharmaceutical Business Administration, Hogeschool Utrecht, Utrecht, The Netherlands
  5. 5 Department of Clinical Pharmacy, OLVG, Amsterdam, The Netherlands
  1. Correspondence to Dr Tjerk H Geersing, Department of Clinical Pharmacy, St Antonius Hospital Location Utrecht, Utrecht, 3543 AZ, Netherlands; t.geersing{at}


Background The increasing amount of hazardous preparations in combination with shortages leads to a call for more efficient compounding methods. This research aims to evaluate the required amount of time, production capacity and direct labour costs of the manual, manual software-supported and robotic compounding of parenteral hazardous drugs.

Methods This multicentre study was conducted at the clinical pharmacy departments of three Dutch hospitals with different compounding methods: St Antonius hospital (manual software-supported compounding), Amsterdam University Medical Centre (Amsterdam UMC) (both robotic compounding and manual compounding without software support) and OLVG (robotic compounding). Time measurements of individual hazardous drugs were performed in all three hospitals. At Amsterdam UMC and St Antonius hospital, the times per compounding phase, the production capacity and the direct labour costs per preparation were also determined. To reflect real-world situations, the combination of robotic and manual compounding was also studied.

Results The total compounding process, including the actions before compounding and the release-time and cleaning time, lasted 6:44 min with robotic compounding and was faster than manual compounding with and without software support (6:48 and 9:48 min, respectively). The production capacity of one full-time equivalent (FTE) on 1 day (P1FTE1day) was 15 preparations per FTE per day with manual compounding with and without software support, and 57 preparations per FTE per day with only robotic compounding. If manual and robotic compounding were combined, the production capacity was 30 preparations per FTE per day. In this setting, the direct labour costs per preparation were €5.21, while these costs were €13.18 with only manual compounding.

Conclusion Compared with manual compounding, robotic compounding was faster over the total compounding process. A combination of manual compounding and robotic compounding could lead to 100% more preparations per FTE and 2.5 times lower direct labour costs compared with manual compounding.

  • Robotics
  • Drug Compounding
  • Antineoplastic agents
  • Automation
  • Health Care Economics and Organizations

Data availability statement

Data are available upon reasonable request.

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