Everyone knows that generally the cost of unit dose syringes can be higher than having a bulk vial of drug on hand and drawing doses up individually. But is it really?
The easy way to find out is to compare the cost of the unit dose syringe to the cost of a bulk vial that is divided by the number of unit doses that can be drawn out of it. In that sense it probably is true, but let’s look at the other costs and benefits.
In the Feb. 7, 2017, post by David Wild in Pharmacy Practice News (available with free registration), it was stated that the cost of abandoned doses due to bulk drugs being prepared was more than $150,000. If you consider ordering a bulk amount of drug, there almost certainly will be waste associated with it.
There is also the patient safety factor. This has two avenues to go down. One is the number of misadministrations that can be cut down by using unit doses. The article from the Journal of Patient Safety cited by Wild in his post stated a reduction from around a 75-percent error rate to one in the single digits. This is also confirmed by the fact that The Joint Commission, Institute for Safe Medicine Practices and the Center for Disease Control and Prevention strongly encourage or mandate the use of single dose (or the most readily usable form) rather than multi-dose vials whenever possible. The cost of non-compliance or not following best practices can have their own costs associated with it. Having multiple inventories of bulk drug can contribute to compounding errors as well as, switching focus from treating the patient to preparing the dose (both critical actions in and of themselves) and then back again to the administration of the dose. And also ensuring all of the correct supplies and processes are used and followed to compound the dose can needlessly create a complicated task when considering the ease of use from an already prepared patient unit dose.
The other avenue of patient safety is confirming that the unit dose is prepared following the USP <797> guidelines. When the dose is filled and dispensed from a pharmacy, this is much safer than drawing up a dose at bedside or similar environment. Also, creating the facility, processes, and training to follow USP <797> can be a significant cost in time and in resources, so outsourcing that practice for unit dose use also makes financial sense. Creating the space for a distraction-free zone to prepare the dose — which is recommended — can also become a resource burden.
Lastly, there is the cost of time. Having personnel take the time to draw up the unit dose accurately from a bulk vial is time taken away from the direct task of treating the patient and administering them the drug. When paying an employee to spend time reviewing the prescription or order, gathering the supplies, following the policy and documentation of drawing up the dose, the costs can add up quicker than you realize.
In review of these hidden costs, is it really more expensive to order unit doses rather than a bulk vial? Reducing waste by ordering unit doses for identified patients, reducing errors, following best or mandated practices, ensuring safely administered injectable doses, and reducing time from staff to make a more efficient process should all add up to an eye opening realization.
Jubilant Radiopharma puts the safety of your patients and the quality of our radiopharmaceuticals above all else. Unit dose dispensing is commonly considered the best practice in nuclear medicine.