Impact of centralised reconstitution of biological medicines on the amount and costs of medicine waste
Year: 2025
Type: article
Abstract: OBJECTIVES: To evaluate the impact of centralising the reconstitution of biological medicines from hospital wards to a hospital pharmacy aseptic facility on the amount and costs of medicine waste. METHODS: Data from 1 January 2021 to 30 November 2021 were collected from an electronic patient record system, including dose, timing and site of the administration of infliximab, rituximab and vedolizumab across 31 wards. The average wholesale prices were obtained from the Finnish national database. Three hypothetical models were compared. In Model A, the medicine residual was discarded after reconstitution on the ward. In Model B, the medicine residual was reused on the ward within the next 12 hours for the subsequent reconstitutions. In Model C, all medicine reconstitutions were centralised. Mean medicine waste costs were calculated and compared between models. Regression analysis was conducted to assess the relationship between ward size and medicine waste costs. RESULTS: The total calculated medicine waste costs at wholesale prices were higher in decentralised models (Models A and B) compared with the centralised model (Model C). The largest cost savings between Models A and C were observed with rituximab (€110 012), while the smallest were with vedolizumab (€46 162). Comparing Models B and C, rituximab also had the greatest savings (€73 524), with infliximab showing the least (€23 014). The number of reconstituted medicines was associated with higher waste costs. A 10% increase in reconstituted medicines led to a 3.1% decrease in relative waste costs. CONCLUSIONS: Centralisation may reduce the amount and costs of medicine waste. However, other associated factors should also be considered, such as transport and storage of ready-to-administer medicines, personnel costs and the impact on the quality and safety of care.
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4409529448