Simplivia Blog

The primary purpose of a closed system transfer device (CSTD) is to limit potential exposure to hazardous drugs and to prevent drug contamination. CSTDs are used when compounding and administrating hazardous chemotherapy drugs. Healthcare professionals, especially nurses working in oncology or pharmacists in compounding pharmacies, use CSTDs to protect themselves, their patients, and their work environment from aerosols, vapors, and harmful droplets of chemotherapy drugs.¹

CSTDs protect healthcare professionals from potential costly healthcare issues by reducing occupational exposure to hazardous drugs. In addition, CSTDs deliver economic benefits by reducing wasted medication through drug vial optimization and by extending beyond use dating.

One way that CSTDs can contribute to savings is drug vial optimization (DVO). This practice requires some additional testing to satisfy safety standards, but, when done correctly, can give healthcare facilities potential cost savings. DVO can potentially reduce the amount of wasted medication that's left over in a vial after the patient-specific doses are compounded.²

A study conducted in 2016 estimated that the United States could spend close to $2 billion annually on oncology drug products that are ultimately be discarded.³ Why? Because they are supplied to pharmacies in vials containing a volume of the drug product that is more than is needed for most doses. Using CSTDs has demonstrated promise in optimizing the use of leftover drug products.⁴

According to U.S. Pharmacopeia (USP) Chapter 797, a single-use vial of medication remains potent for six hours after puncture, provided it is maintained during that time in an environment that meets ISO-5 cleanroom classification. In addition, a study by the University of Toronto found that attaching a CSTD adapter to single-use vials maintained in an ISO-5 cleanroom environment could maintain sterility through multiple withdrawals during 5 days." The cost savings implications at the time of the study (2014/2015) included:

• By adhering to chemical stability and conducting preparation in an ISO-5 cleanroom environment, but not discarding vials with partial dosage amounts remaining after the USP<797> six-hour threshold, annual drug waste in a cancer center pharmacy was $185,000 ($231,446 in current dollar value).
• By contrast, estimates of annual drug wastage if the six-hour threshold is observed and partial vials discarded would be more than $3.09 million in today's dollars.
• Using a CSTD on every single-use vial would save an estimated $3.2 million in drug costs annually.
• The pharmacy system at the Sunnybrook Health Sciences Centre of the University of Toronto estimates the incremental cost of a CSTD system within their outpatient oncology program to be $400,000 annually. The estimates of drug expenditures of $20.4 million annually, with approximately 25,000 patient visits for treatment, predicted a cost savings of over $2 million.⁵

The University's results remained consistent when the vials were continuously exposed to ISO-5 cleanroom air quality and when the Laminar air flow hood was turned off, exposing the vials to less than ISO-5 cleanroom air quality.⁵

Multiple varieties of CSTDs have been used in the United States for nearly three decades. One of their primary purposes is to protect pharmacy staff, nurses, patients, and others who work in or visit a hospital or clinic. Improvements and upgrades over the years have increased the level of protection they afford. This has, in turn, lowered the incidence of injury and compensation claims and the time missed from work because of employment-related injury.⁶

Approximately 4.9 million workers compensation claims are filed yearly, costing about $63 billion between cash payments and medical benefits. Overall employer costs in 2021 were $100.2 billion. The healthcare industry had a 24% increase in workers' compensation claims in 2019.⁸

In today's world of healthcare, CSTDs are a cost-saving expenditure. It was once thought that negative pressure and laminar hoods were enough to protect pharmacists and ensure the sterility of products, but it is clear it takes more. Today, regulations and guidelines mandate the use of CSTDs to reduce occupational exposure to hazardous drugs and the resulting health risks.⁷

A workers compensation claim takes a financial toll on organizations. But the economic costs aren't the only damage done. Employees filing claims against a hospital or clinic also damages the reputation of the facility and employee morale. That too is significant justification for implementing CSTDs.⁹

Simplivia’s Chemfort^® Closed System Drug-Transfer Device product family, and the extended Closed Administration portfolio for nurses, comprise an innovative, vial-to-vein solution that provides safety and inspires confidence.

Brilliantly simple to use and cost-effective, Chemfort^® CSTD and Closed Administration is a safe, closed system that reduces the risk of exposure to hazardous drugs.¹⁰

For more information and to book a demo, contact us.