Cost assessment for the implementation of an intravenous admixture service in a hospital on the southwest border of Brazil

Abstract

Objective: The objective of this study was to evaluate the cost for the implementation of an intravenous medication mixing center (CMI) in a philanthropic hospital on the southwestern border of Brazil. Methods: A survey of the costs of equipment, furniture, utensils and human resources required by the current legislation for the implementation of the CMI was carried out. In addition, an analysis of prescriptions was performed from hospitalized patients in Adult (UTI-AD) and Neonatal (UTI-NEO) Intensive Care Units (July to December/2020) who used injectable drugs. The costs of those medication and of losses for leftover medication were estimated. Seven drugs/mixtures were then selected as a proposal to carry out a pilot test for the implementation of the CMI. Results: The costs involving the physical area, furniture, equipment and materials were estimated at US$ 10,446.52. It is also estimated that it would be necessary to employ at least 2 pharmacists, 4 pharmacy assistants and 2 more students, with monthly costs calculated around US$ 2,267.80, excluding labor charges. The estimated total cost of intravenous drugs, solutions and materials to meet medical prescriptions for the 169 patients included in the study was US$ 24,748.13. Considering that the hospital does not have a CMI to centralize the preparation of unit doses of injectable drugs, a total loss of medication leftovers was estimated at approximately US$ 7,764.64. For pilot testing, the following preparations were suggested: omeprazole, heparin, midazolam and insulin (UTI-AD), electrolyte solutions, ampicillin and gentamicin (UTI-NEO). Conclusion: Although the implementation of a CMI requires significant resources, it would provide greater patient safety and an estimated savings of 31.4% with injectable drugs costs.