Presentation (CTI)

OBJECTIVES: To quantify the financial value of consumables used in a Cytotoxic Reconstitution Unit (CRU) over a six-year period and to propose a cost-recovery strategy for unbilled expenditures through the implementation of differentiated per-cycle preparation fees.
METHODS: A retrospective descriptive pharmacoeconomic study was conducted within the CRU from 2020 to 2025. Four categories of consumables were analyzed: preparation medical devices (MD), personal protective equipment (PPE), dilution solvents, and disinfectants. Quantities consumed over six years were retrieved from inventory management records and valued at applicable unit purchase prices. Daily, weekly, monthly, and annual costs were calculated. Based on an average of 50 preparations per day, differentiated billing fees per chemotherapy cycle were simulated to assess their capacity to offset identified expenditures.
RESULTS: The total valuation of consumables over the six-year period amounted to €600,000, averaging €100,000/year. The most costly categories were chemotherapy dilution and administration devices (€370,000). The entire expenditure represents a net financial loss to the institution, as none of these costs are currently billed to patients. A differentiated fee system was proposed according to preparation type: Fee 1: Syringe preparation: €12, and Fee 2 : Infusion bag preparation: €33. Based on 50 daily preparations with an equal distribution between both types (25 syringes and 25 bags per day), the total daily revenue generated would reach €1,125/day, approximately €22,500/month and €270,000/year. This amount would not only fully cover consumable expenditures, but also generate a surplus to anticipate price increases, renew equipment, and invest in continuous quality improvement.
CONCLUSIONS: This study highlights a significant budget impact Associated with unbilled chemotherapy preparation costs. The implementation of differentiated preparation fees represents a viable and equitable pharmacoeconomic solution to offset these expenditures, safeguard the CRU's budget, and ensure the long-term sustainability of oncological preparation quality.