THE ECONOMICS OF A PHARMACY-BASED CENTRAL INTRAVENOUS ADDITIVE SERVICE FOR PEDIATRIC-PATIENTS

This study was designed to compare the costs of a pharmacy-based Centr al Intravenous Additive Service (CIVAS) with those of traditional ward -based preparation of intravenous doses for a paediatric population. L abour costs were derived from timings of preparation of individual dos es in both the pharmacy and ward by an independent observer. The use-o f disposables and diluents was recorded and their acquisition costs ap portioned to the cost of each dose prepared. Data were collected from 20 CIVAS sessions (501 doses) and 26 ward-based sessions (30 doses). I n addition, the costs avoided by the use of part vials in CIVAS was ca lculated. This was derived from a total of 50 CIVAS sessions. Labour, disposable and diluent costs were significantly lower for CIVAS compar ed with ward-based preparation (p < 0.001). The ratio of costs per dos e [in 1994 pounds sterling (pound)] between ward and pharmacy was 2.35 : 1 (pound 2.51 : pound 1.07). Sensitivity analysis of the best and wo rst staff mixes in both locations ranged from 2.3: i to 4.0: 1, always in favour of CIVAS. There were considerable costs avoided in CIVAS fr om the multiple use of vials; the estimated annual sum derived from th e study was pound 44 000. In addition, CIVAS was less vulnerable to un anticipated interruptions in work flow than wardbased preparation. CIV AS for children was more economical than traditional ward-based prepar ation, because of a cost-minimisation effect. Sensitivity analysis sho wed that these advantages were maintained over a full range of skill m ixes. Additionally, significant savings accrued from the multiple use of vials in CIVAS.