LAUSR

Objectives: Preparation errors occur frequently during conventional multiple step preparation of parenteral drugs at the bedside, causing potential adverse drug events (ADEs), which can be a burden to the patient and involves high costs for the national healthcare system. The use of ready-to-administer (RTA) pre-filled sterilized syringes (PFSS) produced by the hospital pharmacy can prevent a significant part of preparation errors and reduces the risk of bacteremia due to contamination of the intravenous fluid. This research aims to compare the total cost of the conventional preparation methods (CPM) with the PFSS method. Methods: In the analysis, costs related to the preparation of the drugs, bacteremia due to contamination, ADEs as a result of medication errors and wastage of syringes were taken into account. Annual costs in a general Dutch hospital were consistently calculated. Three scenarios were investigated: (i) all preparations CPM (864.246 administrations per year); (ii) all preparations as PFSS; and (iii) 200.000 PFSS and the remaining part CPM (reflecting a transition state as currently present). Deterministic and probabilistic analyses are performed. Results: The first scenario shows higher annual costs at € 10.862.609 compared to the second scenario. The current situation (third scenario) already shows savings of € 2.420.545 compared to the old situation (first scenario). Sensitivity analyses revealed that cost savings of PFSS were mainly the result of decreased risks of medication errors and contamination of intravenous fluids. Extrapolating these results nationwide indicates potential savings over € 300 million if only PFSS were used Conclusions: The use of PFSS prepared at the hospital pharmacy yielded cost-savings compared to conventional preparation at the bedside in the Dutch hospital.