Photo by Dawn Huczek, licensed under CC BY 2.0
Reducing drug waste is a huge challenge for hospital pharmacies. They must always ensure they have sufficient quantities of quality compounded sterile preparations for their patients that meet all applicable regulations. But, they are constantly at risk of ending up with unusable surpluses that must be discarded.
According to the National Academy of Medicine, waste is an issue affecting the entire health care system, estimated at $765 billion a year. That’s money that could be much better served on patients, staff, and facilities.
To avoid drug waste from compounded sterile preparations, hospital pharmacies must strike the right balance between purchasing from 503B outsourcing facilities and compounding sterile preparations in-house. This latter approach is called “rightsourcing” and it can help your hospital reduce drug waste. Let’s take a closer look.
Considerations When Rightsourcing
A proactive rightsourcing strategy can enable your hospital pharmacy to continue serving patients while staying ahead of drug shortages. Finding the right balance requires considering several factors.
Outsourcing
When outsourcing, you’re limited to the 503B facility’s Beyond-Use Date (BUD) and by their form factor (e.g. a 3mL syringe or a 5mL syringe). If the volume typically required for a surgical case doesn't fully utilize that 503B's sterile preparation form factor, you're wasting the remaining volume in that syringe.
Sterile compounds purchased from a 503B may be more expensive than those produced in-house, and waste caused from remaining volume or expired products can quickly add up. If you’re purchasing an expensive resource and throwing the majority of it away, does it make sense to continue outsourcing?
Insourcing
There are different considerations when insourcing. You’ll need to evaluate whether you have the staff and cleanroom capacity to produce these sterile compounds in large batches. You’ll also need adequate storage management capabilities, including where the starting components and final compounds are kept, whether they can be stored properly, and how they are distributed.
Additionally, BUDs for insourced drugs are based on factors such as the literature review, USP-NF monographs, the physical environment for production, and the risk profile of preparation. These can be difficult to document and manage.
Having a Compounding Management System in place will manage master formulations, assure repeatable processes through a technology assisted workflow, and produce a Compounding Record that serves as the single source of truth for auditing and process improvement.
Rightsourcing requires evaluating and addressing insourcing considerations—and the cost of outsourcing—to find the right balance and avoid drug waste.
Contact ConsortiEX today to learn more about how a compounding management system helps your OR pharmacy better manage sterile compounding to avoid drug waste.