Methodology for the Monetization of Vial Remnants in the Aseptic Unit

OBJECTIVES: There is an expressed need to reduce drug wastage during the preparation of high-cost intra-venous treatments. Aseptic Unit Leads across hospitals in Spain, shared a common practice; the optimization of vials remnants (leftovers) utilizing different manual accounting methods (i.e. manual or electronic spreadsheets) with the intention of using them at the next opportunity. The objective is to discuss current processes for the optimization vial remnants and describe the methodology followed to calculate the financial value of the vial remnants at an individual hospital.

METHODS: Following this manual accounting methods, tracking lot numbers and expiry dates becomes a real burden. Hence this tracking is not frequently done, resulting on missing on drugs´ traceability. Not having the ability to trace treatments impacts on inventory management and constitutes a risk to patients in case of recalls.

To calculate the remnants generated, the theoretical units needed from doses prescribed were deducted from the final units used (that could or not include the use of remnants).

To calculate the financial value of the remnants, 13,740 preparations were analyzed. There were two cohorts of data points used for the calculations; data related to prescriptions (size of the vial), doses prescribed, theoretical units (vials) needed, final units (vials) used), and data related to costs (cost per vial, cost per unit of measurement, cost per unit of measurement per vial).

RESULTS: No. of preparations = 13,740; Cost of preparations (IV Drug Budget) = 5.503.095,39€; Value of Remnants = 549.946,44 €

According to the interviewees, manual methods achieve the optimization of a maximum of 80% of the remnants. The other 20% gets unavoidably wasted due to stability challenges and expiration of the medication.

CONCLUSIONS: Financial outcomes outweigh the risks when optimizing remnants.

More research is needed to validate solutions that digitalize the workflow that optimize the use of remnants.