Abstract
BACKGROUND: Due to the toxicity of drugs involved, chemotherapy represents an high-risk treatment, both for operators and patients. To improve the safety of the oncologic therapy admixture process, in 2007 the clinical pharmacy introduced an automated system for the compounding of toxic drugs. The system is integrated with the hospital electronic medical record (EMR) and assures high levels of quality controls and a total traceability of the entire process. PURPOSE: Since the safety and high-quality standards of the re-engineered process have been assessed,(1) the purpose of this study is to evaluate also its economic sustainability and the related production efficiency. MATERIAL AND METHODS: To assess the economic sustainability of the automation, a cost analysis has been performed. Fixed costs (equipment investment, maintenance, human resources, personal protective equipments) and variable costs (compounding disposables and administrative management of the process) have been calculated both for the manual and automated compounding model, and the consequent differential saving has been estimated. In addition, we have evaluated the possibility of also centralising the production by taking into consideration the need of other hospitals and healthcare facilities in the region. RESULTS: The re-engineering of the onco-haematology process led to an annual saving of €85.715, with a marginal saving of €5.49 per preparation, a break-even point of 4.1 therapies and a return on investment in 3.3 years (against 8 years’ life-time of the robotic system). Furthermore, the total automated production capacity is estimated in 24.865 preparations per year where the 79.3% is sufficient to cover the annual hospital (hub) needs. Therefore, the residual capacity, corresponding to 5.145 annual preparations, can be allocated to satisfy the requests coming from other compounding facilities (spokes). CONCLUSION: Besides the minimisation of the risks related to the automated production and the benefits coming from the re-engineering of the process,(1) the economic sustainability of the investment and the production centralisation feasibility have been demonstrated. REFERENCE AND/OR ACKNOWLEDGEMENTS: 1. Bufarini C, et al. Safe and integrated onco-haematology workflow, 19th EAHP Congress 2014. No conflict of interest