title: Ready-to-use pre-filled syringes of atropine for anaesthesia care in French hospitals - a budget impact analysis.
abstract: BACKGROUND
  Patient safety is improved by the use of labelled, ready-to-use, pre-filled syringes (PFS) when compared to conventional methods of syringe preparation (CMP) of the same product from an ampoule. However, the PFS presentation costs more than the CMP presentation.
  
  
  OBJECTIVE
  To estimate the budget impact for French hospitals of switching from atropine in ampoules to atropine PFS for anaesthesia care.
  
  
  METHODS
  A model was constructed to simulate the financial consequences of the use of atropine PFS in operating theatres, taking into account wastage and medication errors. The model tested different scenarios and a sensitivity analysis was performed.
  
  
  RESULTS
  In a reference scenario, the systematic use of atropine PFS rather than atropine CMP yielded a net one-year budget saving of €5,255,304. Medication errors outweighed other cost factors relating to the use of atropine CMP (€9,425,448). Avoidance of wastage in the case of atropine CMP (prepared and unused) was a major source of savings (€1,167,323). Significant savings were made by means of other scenarios examined. The sensitivity analysis suggests that the results obtained are robust and stable for a range of parameter estimates and assumptions.
  
  
  CONCLUSIONS
  The financial model was based on data obtained from the literature and expert opinions.
  
  
  CONCLUSIONS
  The budget impact analysis shows that even though atropine PFS is more expensive than atropine CMP, its use would lead to significant cost savings. Savings would mainly be due to fewer medication errors and their associated consequences and the absence of wastage when atropine syringes are prepared in advance.
authors.affiliation: AP-HP, CHU de Bicêtre, hôpitaux universitaires Paris Sud, hôpital Bicêtre, service anesthésie-réanimation, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.
authors.forename: Dan
authors.initials: D
authors.lastname: Benhamou
authors.affiliation: Hospices Civils de Lyon Sud, service d'anesthésie-réanimation, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Piriou
authors.affiliation: Clinique Saint-Jean l'Hermitage, unité d'anesthésie pôle ASUR, 41, avenue de Corbeil, 77000 Melun, France.
authors.forename: Cyrille
authors.initials: C
authors.lastname: De Vaumas
authors.affiliation: Hôpital Michallon, anesthésie-réanimation, avenue Maquis-du-Grésivaudan, 38700 La Tronche, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Albaladejo
authors.affiliation: Hôpital Maison-Blanche, service d'anesthésie-réanimation, 45, rue Cognac-Jay, 51092 Reims cedex, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Malinovsky
authors.affiliation: Cemka-Eval, 43, boulevard Maréchal-Joffre, 92340 Bourg-la-Reine, France. Electronic address: marianne.doz@cemka.fr.
authors.forename: Marianne
authors.initials: M
authors.lastname: Doz
authors.affiliation: Cemka-Eval, 43, boulevard Maréchal-Joffre, 92340 Bourg-la-Reine, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Lafuma
authors.affiliation: CHU, CHRN anesthésie-réanimation, hôpital central, service anesthésie-réanimation, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy cedex, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Bouaziz
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage* / Q000191:economics*; D000758:Anesthesia; D001285:Atropine / Q000008:administration & dosage* / Q000191:economics*; D002017:Budgets; D017046:Cost Savings; D005602:France; D006761:Hospitals; D006801:Humans; D008506:Medical Waste / Q000191:economics; D008508:Medication Errors / Q000191:economics / Q000517:prevention & control; D018803:Models, Economic; D013594:Syringes
chemical_list: D000759:Adjuvants, Anesthesia; D008506:Medical Waste; D001285:Atropine
keywords: Anaesthesia; Atropine; Budget impact analysis; Conventional methods of preparation (CMP); Health economics; Pre-filled syringes (PFS); Ready-to-use intravenous drugs