RT Journal Article SR Electronic T1 Cost-effectiveness of two technology-assisted manual medication picking systems versus traditional manual picking in a hospital outpatient pharmacy JF European Journal of Hospital Pharmacy JO Eur J Hosp Pharm FD British Medical Journal Publishing Group SP ejhpharm-2019-001997 DO 10.1136/ejhpharm-2019-001997 A1 Marcus Eng Hwa Teo A1 Bih Yee Chia A1 Yeng Ching Lee A1 Pearlyn Li Ying Tay A1 Jane Ai Wong A1 Soo Boon Lee A1 Mun Moon Lim A1 McVin Hua Heng Cheen YR 2019 UL http://ejhp.bmj.com/content/early/2019/11/14/ejhpharm-2019-001997.abstract AB Objective To evaluate the cost-effectiveness of two technology assisted manual medication picking systems vs traditional manual picking.Methods This was a retrospective observational study comparing three outpatient pharmacies of a tertiary referral hospital in Singapore, where a light-emitting diode (LED-guided) manual picking system, an LED-guided manual picking plus lockable drawer (LED-LD) system, and traditional manual picking were implemented, respectively. The primary outcome measure was the incidence of medication near-misses over the observation period. The incremental cost-effectiveness ratio (ICER) per near-miss avoided was also determined. Data on medications picked and near-misses reported between September 2017 and June 2018 were retrieved from electronic databases. The incidence of medication near-misses from the LED-guided and LED-LD systems, relative to traditional picking, was compared using logistic regression. We compared annual operating costs between manual medication picking systems, and reported ICERs per near-miss avoided, to evaluate the cost-effectiveness of each picking system.Results A total of 358 144, 397 343 and 254 162 medications were picked by traditional manual picking, LED-guided and LED-LD systems, respectively. The corresponding near-miss rates were 8.32, 4.08 and 0.69 per 10 000 medications picked, respectively. Medication near-miss rates were significantly lower for the LED-guided (OR 0.49, 95% CI 0.40 to 0.59, p<0.001) and LED-LD systems (OR 0.08, 95% CI 0.05 to 0.13, p<0.001) compared with traditional picking. The annual operating costs of traditional picking, LED-guided and LED-LD systems were S$60 912, S$129 832 and S$152 894, respectively. The LED-guided and LED-LD systems yielded ICERs of S$189 and S$140 per near-miss avoided, respectively, compared with traditional manual picking.Conclusion The LED-LD system is more cost-effective than both the LED-guided and manual medication picking systems in reducing medication picking near-misses.