Evaluation of Cost,Workflow,and Safety of Implementing a Vial Transfer Device for Ready-to-Mix Drugs at an Academic Medical Center

Abstract

Objective:

To evaluate the cost, workflow, and safety of implementing a vial transfer device system.

Methods:

In this retrospective analysis, pharmacy systems and electronic health record reports identified high-volume and high-cost medications prepared by a Vial2Bag^® (V2B) system from July 2017 to June 2018. The major outcome was the extrapolated yearly cost avoidance (EYCA) from utilization of a V2B system, calculated by subtracting total costs of the V2B system from total cost of ready-to-use products and locally compounded sterile products. Secondary outcomes included a workflow and safety analysis.

Results:

Implementing a V2B system led to a total EYCA of $2 295 261. A total of 283 209 potential V2B units were available for dispensing from automated dispensing systems and 41 082 yearly sterile product room units were avoided. A 0.02% safety report incidence per V2B administration was calculated at our institution.

Conclusion:

Use of a V2B system resulted in a substantial cost avoidance compared to purchasing commercial products and preparing locally compounded sterile products. The V2B system appears to be a safe addition to further optimize workflow but may require further investigation in prospective analyses.

Keywords

vial transfer device cost avoidance sterile product compounding workflow

Get full access to this article

View all access options for this article.

References

Gabay

Hertig

Degnan

. et al. Third consensus development conference on the safety of intravenous drug delivery systems—2018. Am J Health Syst Pharm. 2020;77(3):215–220.

van Zanten

Engelfriet

van Dillen

. et al. Importance of nondrug costs of intravenous antibiotic therapy. Crit Care. 2003;7(6):R184–R190.

Al-Fadel

Mahmoud

Dabliz

. et al. Implementation of safety standards of compounded sterile preparations in hospital pharmacies: a multinational cross-sectional study. Eur J Hosp Pharm. 2016;23(6):339–342.

Fanikos

Erickson

Munz

. et al. Observations on the use of ready-to-use and point-of-care activated parenteral products in automated dispensing cabinets in US hospitals. Am J Health Syst Pharm. 2007;64(19):2037–2043.

Trissel

Gentempo

Anderson

. et al. Using a medium-fill simulation to evaluate the microbial contamination rate for usp medium-risk-level compounding. Am J Health Syst Pharm. 2005;62(3):285–288.

Maliekal

Bertch

Witte

. An update on ready-to-use intravenous delivery systems. Hosp Pharm. 1993;28(10):970–971, 5–7.

Rinaldi

de Denus

Nguyen

. et al. Drug shortages: patients and health care providers are all drawing the short straw. Can J Cardiol. 2017;33(2):283–286.

Hatoum

Witte

Biedron

. et al. Microcosting method for small-volume injectables. Am J Hosp Pharm. 1986;43(2):348–354.

Sherrin

Miller

Latiolais

. Projecting staffing patterns from time study data in centralized intravenous admixture programs. Am J Hosp Pharm. 1972;29(12):1013–1019.

10.

Rosselli

Rueda

Silva

. et al. Economic evaluation of four drug administration systems in intensive care units in Colombia. Value Health Reg Issues. 2014;5:20–24.

11.

Lopez

Cuervo

Toha

. et al. Impact of the implementation of vasoactive drug protocols on safety and efficacy in the treatment of critically ill patients. J Clin Pharm Ther. 2016;41(6):703–710.

12.

Sebastian

Thielke

. Work analysis of an admixture service. Am J Hosp Pharm. 1983;40(12):2149–2153.

13.

Petroff

BJ.

Premixed i.v. admixtures for reducing costs and labor time in a home infusion company. Am J Health Syst Pharm. 2000;57(4):390.

14.

Jelacic

Craddick

Nair

. et al. Relative costs of anesthesiologist prepared, hospital pharmacy prepared and outsourced anesthesia drugs. J Clin Anesth. 2017;36:178–183.

15.

Ryan

Daniels

Somani

. Personnel costs and preparation time in a centralized intravenous admixture program. Am J Hosp Pharm. 1986;43(5):1222–1225.

16.

Tilson

Dobson

Haas

. et al. Mathematical modeling to reduce waste of compounded sterile products in hospital pharmacies. Hosp Pharm. 2014;49(7):616–627.

17.

Hintzen

Knoer

Van Dyke

. et al. Effect of lean process improvement techniques on a university hospital inpatient pharmacy. Am J Health Syst Pharm. 2009;66(22):2042–2047.

18.

Jenkins

Rowe

Granko

. et al. Effects of a new sterile product preparation and delivery process on operational efficiency and cost. Am J Health Syst Pharm. 2010;67(19):1645–1649.

19.

Davis

Hurtado

Nguyen

. et al. Innovations in medication preparation safety and wastage reduction: use of a workflow management system in a pediatric hospital. Hosp Pharm. 2017;52(1):54–59.

20.

Ortega

Robles

Lacasa

. et al. Economic evaluation of viaflex with vial adapter in a unit-dose drug distribution system. Pharm World Sci. 1999;21(6):278–280.

21.

Chapuis

Roustit

Bal

. et al. Automated drug dispensing system reduces medication errors in an intensive care setting. Crit Care Med. 2010;38(12):2275–2281.

22.

DeRon

Craig

Parks

. Monitoring system to verify activation of add-vantage system doses. Am J Hosp Pharm. 1989;46(4):702.