Automated drug dispensing systems in the intensive care unit: a financial analysis.
BACKGROUND
To evaluate the economic impact of automated-drug dispensing systems (ADS) in surgical intensive care units (ICUs). A financial analysis was conducted in three adult ICUs of one university hospital, where ADS were implemented, one in each unit, to replace the traditional floor stock system.


METHODS
Costs were estimated before and after implementation of the ADS on the basis of floor stock inventories, expired drugs, and time spent by nurses and pharmacy technicians on medication-related work activities. A financial analysis was conducted that included operating cash flows, investment cash flows, global cash flow and net present value.


RESULTS
After ADS implementation, nurses spent less time on medication-related activities with an average of 14.7 hours saved per day/33 beds. Pharmacy technicians spent more time on floor-stock activities with an average of 3.5 additional hours per day across the three ICUs. The cost of drug storage was reduced by €44,298 and the cost of expired drugs was reduced by €14,772 per year across the three ICUs. Five years after the initial investment, the global cash flow was €148,229 and the net present value of the project was positive by €510,404.


CONCLUSIONS
The financial modeling of the ADS implementation in three ICUs showed a high return on investment for the hospital. Medication-related costs and nursing time dedicated to medications are reduced with ADS.
Pôle Pharmacie, CHU Grenoble, Hôpital Michallon, CS 10217, F-38043, Grenoble, France. CChapuis1@chu-grenoble.fr.
Claire
C
Chapuis
Pôle Pharmacie, CHU Grenoble, Hôpital Michallon, CS 10217, F-38043, Grenoble, France. PBedouch@chu-grenoble.fr.|Université Grenoble Alpes/CNRS, ThEMAS TIMC UMR 5525, Grenoble, F-38041, France. PBedouch@chu-grenoble.fr.
Pierrick
P
Bedouch
Pôle Pharmacie, CHU Grenoble, Hôpital Michallon, CS 10217, F-38043, Grenoble, France. MDetavernier@chu-grenoble.fr.
Maxime
M
Detavernier
Pole Anesthésie-Réanimation, Hôpital Michallon, Grenoble, F-38043, France. MDurand@chu-grenoble.fr.
Michel
M
Durand
Pole Anesthésie-Réanimation, Hôpital Michallon, Grenoble, F-38043, France. GFrancony@chu-grenoble.fr.
Gilles
G
Francony
Pole Anesthésie-Réanimation, Hôpital Michallon, Grenoble, F-38043, France. PLavagne@chu-grenoble.fr.
Pierre
P
Lavagne
Pôle Pharmacie, CHU Grenoble, Hôpital Michallon, CS 10217, F-38043, Grenoble, France. LForoni@chu-grenoble.fr.
Luc
L
Foroni
Université Grenoble Alpes/CNRS, ThEMAS TIMC UMR 5525, Grenoble, F-38041, France. PAlbaladejo@chu-grenoble.fr.|Pole Anesthésie-Réanimation, Hôpital Michallon, Grenoble, F-38043, France. PAlbaladejo@chu-grenoble.fr.
Pierre
P
Albaladejo
Pôle Pharmacie, CHU Grenoble, Hôpital Michallon, CS 10217, F-38043, Grenoble, France. BAllenet@chu-grenoble.fr.|Université Grenoble Alpes/CNRS, ThEMAS TIMC UMR 5525, Grenoble, F-38041, France. BAllenet@chu-grenoble.fr.
Benoit
B
Allenet
Université Grenoble Alpes/CNRS, ThEMAS TIMC UMR 5525, Grenoble, F-38041, France. Jean-Francois.Payen@ujf-grenoble.fr.|Pole Anesthésie-Réanimation, Hôpital Michallon, Grenoble, F-38043, France. Jean-Francois.Payen@ujf-grenoble.fr.
Jean-Francois
JF
Payen
D001331:Automation / Q000191:economics / Q000379:methods; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D017721:Hospital Costs / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000191:economics / Q000458:organization & administration; D006801:Humans; D007362:Intensive Care Units / Q000191:economics* / Q000458:organization & administration; D008510:Medication Systems, Hospital / Q000191:economics* / Q000458:organization & administration