Background and Importance The cost of unused antiblastic therapies (UAT) has a considerable impact on a General Hospital (GH) budget. In order to optimise resources allocation/limit waste, it is possible to analyse the process that goes from the physician request for patient care to validation carried out by the Hospital Pharmacist, to preparation/distribution/therapy administration for detecting weak points and turn towards a more sustainable company modus operandi.

Aim and Objectives Objective of the study was to analyse antiblastic drug management process in a GH, by means of Root Cause Analysis, detecting weak links economic consequences and promoting corporate awareness work on the issue.

Material and Methods The analysis covered the period December 2022 to May 2023. According to data collected, an Excel file was drawn up (showing protocol name/dosage/department/non-administration reason); it was also specified whether therapy was reused for another patient or disposed of and, if so, how much this choice has impacted on GH’s expenditure, making an estimate of the monetary value costs incurred for drug/preparation. An audit composed of physicians/pharmacists/nurses met to investigate non-administration causes for finding a sustainable company policy.

Results Of 12,150 therapies set up, 97 were UAT; of these, 26/97 were re-used and 71/97 disposed of, for an economic loss of approximately 33,961.82 Euros, considering an estimate of 150 Euros for set-up costs (personnel-resources employed). Root Cause Analysis showed that the main reasons for non-administration were: prescribing errors 7.22% (7/97), inability to reach GH 20.6% (20/97), Adverse Drug Reactions (ADRs) 44.33% (43/97), illness not ADRs related 14.43% (14/97), other factors [anti-Covid test positivity, therapy refusal, falls, etc] 13.40% (13/97).

Conclusion and Relevance For each non-administration reason corrective actions were identified. It would be desirable for Physician to confirm therapy to Compounding Antiblastic Unit (CAU) only when knows really that patient can receive it, following the visit/assessment of clinical analyses, to direct therapies setting up only towards patients who are truly eligible for conditions/availability/therapeutic reconciliation. Ideal would be the timely communication to CAU of any UAT so that it can be assessed, according to drug’s technical data sheet, whether drug can be reused on the same day or within the stability time. Finally, it would be useful having software alert/constraint system for cycles exceeding numbers permitted, established at the time of protocol coding.

Conflict of Interest No conflict of interest.