Cost saving and safety associated with centralised cytotoxic medicine reconstitution at National Hospital Kandy in 2019
Abstract
Background: Cytotoxic medicines are associated with occupational risks to the operators. Therefore, centralised cytotoxic medicine reconstitution by trained pharmacists was initiated in Sri Lanka in 2009. Centralised parenteral medicine reconstitution has many advantages such as quality assurance, error reduction, wastage reduction and cost saving. However, none of these have been analyzed and reported in Sri Lankan settings before this study. If the cost saving is of a considerable value, Centralised Medicine Reconstitution (CMR) can be applied to other expensive medicines which will help to reduce the cost of medical supplies.
Objectives: To analyse the cost saving and increased safety by reducing the medicine wastage due to the centralised parenteral cytotoxic medicine reconstitution in the National Hospital Kandy (NHK) in 2019.
Methods: The study was conducted using the data recorded in 2019 on the daily medicine balance book maintained at the Cytotoxic Reconstitution Unit (CRU) in NHK. The number of vials used, the quantity of each dose, and the price of the parenteral cytotoxic medicine were used to calculate the total cost and the medicine wastage in the CRU and ward, and compared.
Results: Theoretical medicine cost in wards to dispense 24 medicines was LKR 267.7 million, while the cost in the CRU was LKR 193.9 million. When it was reconstituted by the CRU, there was a wastage of 213,744.60 mg, and in wards, it was 4,353,153.60 mg. It showed a cost savings of LKR 73.8 million and a savings of 4,139,409 mg due to the CMR. The majority of cancer medications are cytotoxic, so reduction of medicine wastage also lowers the occupational risk and the risk to the environment.
Conclusion: CMR of cytotoxic medicine in NHK has shown a 27% cost reduction and increased occupational and environmental safety as determined by 95% reduction in medicine wastage in 2019. CMR of other costly parenteral medicines in addition to the cytotoxics would help to reduce the cost on medicines.
Objectives: To analyse the cost saving and increased safety by reducing the medicine wastage due to the centralised parenteral cytotoxic medicine reconstitution in the National Hospital Kandy (NHK) in 2019.
Methods: The study was conducted using the data recorded in 2019 on the daily medicine balance book maintained at the Cytotoxic Reconstitution Unit (CRU) in NHK. The number of vials used, the quantity of each dose, and the price of the parenteral cytotoxic medicine were used to calculate the total cost and the medicine wastage in the CRU and ward, and compared.
Results: Theoretical medicine cost in wards to dispense 24 medicines was LKR 267.7 million, while the cost in the CRU was LKR 193.9 million. When it was reconstituted by the CRU, there was a wastage of 213,744.60 mg, and in wards, it was 4,353,153.60 mg. It showed a cost savings of LKR 73.8 million and a savings of 4,139,409 mg due to the CMR. The majority of cancer medications are cytotoxic, so reduction of medicine wastage also lowers the occupational risk and the risk to the environment.
Conclusion: CMR of cytotoxic medicine in NHK has shown a 27% cost reduction and increased occupational and environmental safety as determined by 95% reduction in medicine wastage in 2019. CMR of other costly parenteral medicines in addition to the cytotoxics would help to reduce the cost on medicines.
DOI: https://doi.org/10.4038/sljhr.v2i1.50 | Journal eISSN: 2806-5379
Language: English
Page range: 27 - 41
Published on: Dec 31, 2022
Published by: Ministry of Health, Sri Lanka
In partnership with: Paradigm Publishing Services
Keywords:
© 2022 W. T. D. Wickramarathna, B. D. Kumara, A. G. S. U. Bandara, L. C. P. T. Liyanaarachchie, published by Ministry of Health, Sri Lanka
This work is licensed under the Creative Commons Attribution 4.0 License.