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. 2023 Aug 14:16:1521-1530.
doi: 10.2147/RMHP.S418886. eCollection 2023.

Combining the Real-Time Vial Sharing Strategy with Daily-Rate Charge Mode for Antimicrobial Drugs of Inpatients: An Economical and Practical Method for Patients and Hospitals

Jianquan Li  1 , Yongyang He  1 , Xi Lei  1 , Zhongqiang Cao  1 , Yuwei Liao  1 , Guoqiang Wang  1 , Zebin Chen  1 , Xuejuan Li  1 , Xiaoya Liu  1
Affiliations

Combining the Real-Time Vial Sharing Strategy with Daily-Rate Charge Mode for Antimicrobial Drugs of Inpatients: An Economical and Practical Method for Patients and Hospitals

Jianquan Li et al. Risk Manag Healthc Policy. .

Abstract

Background: Antimicrobial agents' wastage is a huge problem, especially for pediatric patients, resulting in excessive drug expenditure and increasing the economic burden on patients' families. Moreover, the cost of disposing of antimicrobial agents' waste and the risk of environmental and occupational exposure also increased. This study aimed to explore the cost-effectiveness of the vial-sharing strategy combined with the daily-rate charge mode for pediatric inpatients to provide a strategy for reducing patients' expenditures, saving medical costs, and reducing drug proportion.

Methods: This retrospective study was conducted at Pharmacy Intravenous Admixture Service (PIVAS), Shenzhen Children's Hospital, Guangdong Province, China, in 2022. Data on prescription drugs were collected from the PIVAS system. Ten antimicrobial drugs with a frequency of prescriptions no less than twice once daily were selected, and the drug costs, drug weight, and drug saved were further analyzed according to the combination of real-time vial sharing strategy and daily-rate charge mode. Traditional single vial charge mode without vial sharing was set as a control strategy. The actual expenditure of the hospital was also calculated and analyzed.

Results: During 2022, ¥ 4,122,099 (34.4%) was saved for inpatients by applying a vial-sharing strategy on ten antibacterial agents, and more than 46,343,750 mg (24.6%) of drugs were totally saved. The top 5 drugs saved by the real-time vial-sharing strategy were cefoperazone-sulbactam, vancomycin, amoxicillin-sulbactam, ceftazidime, and meropenem. Taken the price into consideration, the top five payment-saved drugs were vancomycin (¥ 1,522,385), meropenem (¥ 1,311,475), cefoperazone-sulbactam (¥ 736,697), imipenem-cilastatin (¥ 406,092), and amoxicillin-sulbactam (¥ 51,394). Moreover, the account balance of the hospital was up to ¥ 426,499.

Conclusion: The real-time vial sharing strategy combined with the daily-rate charge mode greatly reduces drug wastage and patients' payments. It may be useful for hospitals with PIVAS to achieve vial-sharing while protecting the best interest of inpatients.

Keywords: PIVAS; antimicrobial drugs; daily-charge mode; inpatients; real-time vial sharing strategy.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Workflow of PIVAS.
Figure 2
Figure 2
Illustration of drug discarded and the actual payment of inpatients prescribed with same drug but without vial sharing and charged in single does mode.
Figure 3
Figure 3
Illustration of drug discarded and the actual payment of inpatients prescribed with same drug with real-time vial sharing and daily-rate charged.
Figure 4
Figure 4
The theoretical number of drugs used in 2022 by single-dose vial strategy and real-time vial sharing strategy. (a) The number of antibacterial drugs vials. (b) The total amount of drugs saved by weight.
Figure 5
Figure 5
The payment of patients for selected drugs by traditional single does charge mode and daily-rate charge mode (a) and the calculated cost saved for inpatients (b).
Figure 6
Figure 6
The ratio of drug saved (a) and cost saved (b) among ten antibacterial drugs.
See this image and copyright information in PMC

References

    1. Dona D, Barbieri E, Daverio M, et al. Implementation and impact of pediatric antimicrobial stewardship programs: a systematic scoping review. Antimicrob Resist Infect Control. 2020;9(1):3–10. doi:10.1186/s13756-019-0659-3 - DOI - PMC - PubMed
    1. Cho JC, Stovall SH. Need for pediatric antimicrobial stewardship. Am J Health Syst Pharm. 2015;72(5):347. doi:10.2146/ajhp140844 - DOI - PubMed
    1. Tersigni C, Venturini E, Montagnani C, et al. Antimicrobial stewardship in children: more shadows than lights? Expert Rev Anti Infect Ther. 2019;17(11):871–876. doi:10.1080/14787210.2019.1686355 - DOI - PubMed
    1. Gopisankar MG, Wahlang J, Jagtap V, et al. Cancer chemotherapy drug wastage in a tertiary care hospital in India-A 3-month prospective and 1-year retrospective study. Br J Clin Pharmacol. 2019;85(10):2428–2435. doi:10.1111/bcp.14064 - DOI - PMC - PubMed
    1. MacBrayne CE, Williams MC, Obermeier H, et al. Anti-infective waste in a pediatric institution: pinpointing problems in the process. Hosp Pharm. 2020;55(4):220–223. doi:10.1177/0018578719844164 - DOI - PMC - PubMed