title: Cost Analysis of Using a Closed-System Transfer Device (CSTD) for Antineoplastic Drug preparation in a Malaysian Government-Funded Hospital
abstract: Background: Apart from reducing occupational exposure to cytotoxic hazards, the PhaSeal® closed-system transfer
  device (CSTD) can extend the beyond-use dates (BUDs) of unfinished vials of antineoplastic drugs for up to 168 hours
  (seven days). In this study, the total material cost incurred by its use in a Malaysian government-funded hospital was
  calculated. Methods: A list of vial stability following initial needle punctures of 29 commonly-used antineoplastic
  drugs was compiled. The amount of the materials used, including drugs, infusion bottles, the PhaSeal® CSTD and
  other consumables, was recorded on a daily basis for three months in 2015. The total cost was calculated based on the
  actual acquisition costs, and was compared with that of a hypothetical scenario, whereby conventional syringe-needle
  sets were used for the same amounts of preparations. Results: The use of the PhaSeal® CSTD incurred a cost of MYR
  383,634.52 (USD 92,072.28) in three months, representing an average of MYR 170.5 (USD 40.92) per preparation
  or an estimated annual cost of MYR 1,534,538.08 (USD 368,289.14). Compared with conventional syringe-needle
  approach, it is estimated to lead to an additional spending of MYR 148,627.68 (USD 35,670.64) yearly. Conclusion:
  Although there was a reduction of drug wastage achieved by extending BUDs of unfinished vials using the PhaSeal®
  CSTD, cost saving was not observed, likely attributable to the wide use of lower-priced generic drugs in Malaysia.
  Future studies should further evaluate the possibility of cost saving, especially in health settings where branded and
  high-cost antineoplastic drugs are more commonly used.
authors.affiliation: Clinical Research Center, Sultanah Bahiyah Hospital, Alor Setar, Malaysia.Email:huankeat123@yahoo.com
authors.forename: Huan Keat
authors.initials: HK
authors.lastname: Chan
authors.forename: Yik Ming
authors.initials: YM
authors.lastname: Lim
keywords: Antineoplastic agents; closed; system transfer device; cost savings; malaysia; occupational exposure