title: Cost savings realized by use of the PhaSeal(®) closed-system transfer device for preparation of antineoplastic agents.
abstract: OBJECTIVE
  Medication cost is a major factor associated with increasing health care costs in the United States. Expenditures for prescription drugs in 2013 are estimated to be $283.7 billion. Closed system transfer devices are widely used for preparation of hazardous drugs. Reports indicate the Phaseal(®) closed system transfer device maintains sterility in vials for 7 days, suggesting the unused portion of single-use vials could be salvaged. This study was done to determine whether using a closed system transfer device to extend the beyond-use date of single-use vials of antineoplastic medications would result in a measurable cost saving.
  
  
  METHODS
  A list of 25 drugs available in single-use vials, with a chemical stability of at least 48 hours, was compiled. Use of these agents was recorded during a 50-day period in April through June 2012. Use from a total of 296 vials of 21 antineoplastic agents was recorded. After allowing for the initial use of each vial, the mean potential percentage of drug waste was calculated to be 57.03%.
  
  
  RESULTS
  Actual savings during the study period was $96,348.70. The pharmacy avoided nearly half of the potential waste and saved a mean of 29% of each vial. The cost-saving during the study period represents a $703,047.67 annual saving; which more than offsets the $106,556.55 the pharmacy spent for the Phaseal(®) system in 2012.
  
  
  CONCLUSIONS
  In addition to being a protective measure to reduce exposure to hazardous agents, use of the Phaseal(®) system results in a reduction in drug waste, and a noticeable cost saving for antineoplastic agents.
authors: Hematology-Oncology Pharmacy Service, Department of Pharmacy, Walter Reed National Military Medical Center, Bethesda, MD, USA.
authors: Michael S
authors: MS
authors: Edwards
authors: Dominic A
authors: DA
authors: Solimando
authors: Franklin R
authors: FR
authors: Grollman
authors: Janet L
authors: JL
authors: Pang
authors: Ashley H
authors: AH
authors: Chasick
authors: Charlene M
authors: CM
authors: Hightman
authors: Anthony D
authors: AD
authors: Johnson
authors: Maxine G
authors: MG
authors: Mickens
authors: Lorenzo M
authors: LM
authors: Preston
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000737:chemistry* / Q000191:economics; D017046:Cost Savings; D004339:Drug Compounding / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D016527:Drug Costs; D004355:Drug Stability; D004356:Drug Storage; D004867:Equipment Design; D006801:Humans; D016273:Occupational Exposure / Q000517:prevention & control*; D013997:Time Factors; D014481:United States
chemical_list: D000970:Antineoplastic Agents
keywords: Beyond use dating; PhaSeal®; USP chapter 797; closed system transfer devices; cost savings; single-use vials