[Risk Benefit of Single Vial Multiple Use(DVO)Using Anti-Cancer Drug Preparation Robot-DVO Drug Selection Aimed at Both Improving Operational Efficiency and Reducing Medical Costs].

Abstract

A cancer drug preparation robot was used to select an optimal drug for drug vial optimization(DVO)and thus reduce medical costs and improve the risk benefit profile. We administered DVO for paclitaxel(PTX)30 mg/100 mg, etoposide(VP-16)100 mg, and oxaliplatin(L-OHP)50 mg/100 mg at Ogaki Municipal Hospital. Comparisons were made for preparation time and drug waste(cost)before and after DVO implementation for each drug over 5, 2, and 2 months respectively. PTX was consolidated from 2 specifications into a single specification(100 mg)with the introduction of DVO. Changes in median preparation times for each drug after implementation of DVO were as follows: for PTX, it decreased from 433 s before implementation to 410 s after implementation(p=0.043). Conversely, for VP-16 and L-OHP, the time increased from 320 and 348 s before implementation to 375 and 362 s after implementation, respectively(both p<0.001). The amounts of drug waste(cost of waste)before and after DVO implementation were as follows: for PTX, it decreased from 1,269.26 mg(77,277 yen)to 327.99 mg(19,037 yen); for VP-16, it decreased from 1,275.6 mg(43,600 yen)to 99 mg (3,384 yen); and for L-OHP, it decreased from 3,563.9 mg(975,660 yen)to 4.48 mg(1,143 yen)(all p<0.001). For the implementation of DVO, drugs must be selected based on waste reduction rates and efficiency gains, especially for high-cost anticancer drugs.