Abstract
BACKGROUND: Robotic systems for chemotherapy preparation offer improved accuracy and staff safety but require substantial capital investment. This study assessed the economic performance of a domestically developed robotic chemotherapy compounding system at Udon Thani Cancer Hospital and its service expansion to a network hospital in Thailand. METHODS: A descriptive study with economic evaluation was conducted, including cost-benefit analysis, unit cost analysis, and break-even analysis from both provider and health system perspectives. Data from fiscal year 2023 were used. Direct and indirect costs were assessed, and clinical outcomes were documented. A scenario-based sensitivity analysis was performed to examine cost variations under different capacity utilisation levels. RESULTS: Robotic preparation had a higher per-dose cost (THB 538 for 4,173 doses) than manual preparation (THB 250 for 20,310 doses), but was associated with total estimated economic benefits of THB 1.88 million, including labour and training savings and improved pharmaceutical care. The break-even point was estimated at 41,802 doses for robotic compounding and 5,122 doses for service expansion. The incremental benefit-cost ratio (IBCR) was 1.566 and increased to 3.018 when including delivery to the network hospital. CONCLUSIONS: The robotic system demonstrated potential economic and operational advantages, particularly when scaled to serve additional facilities. These findings offer preliminary evidence to inform future policy considerations under Thailand's Cancer Service Plan. Further evaluation is needed to assess long-term sustainability and broader system-level outcomes.