How CSTDs Can Improve Your Return on Investment

In the healthcare industry, saving money is crucial to the bottom line. One area where you might be spending more than you should is in the dispensation of medications. Traditional drug-delivery mechanisms encompass costs above and beyond the drugs themselves - there are needles, infusion bottles, and other consumables that add to the total expense. Even when drugs are used judiciously and efficiently, you still may end up discarding expensive drugs simply because you couldn't use them in time.

Closed system drug-transfer devices (CSTDs) can reduce the number of SKUs needed for drug handling protocols. They can also keep your medications sterile and thereby useable for longer. In addition, they protect healthcare staff and enable compliance with relevant regulations and guidelines. Let’s take a closer look at how consistent use of CSTDs can provide meaningful cost efficiencies.

It's no secret that the cost of prescription drugs has skyrocketed in recent years. Drug spending in the United States totaled some $309.5 billion in 2015, which was up 8.5% from 2014. While much of this burden falls on the patients, you are still responsible for ensuring that the drugs they need are in stock. Maintaining supplies of costly drugs can cut deeply into your budget, particularly if you have to dispose of drugs you weren't able to use before the expiration date. USP <797> calls for single-use vials to be disposed of within six hours of opening if maintained in International Organization for Standardization Class 5 air conditions. Following these protocols leads to a loss of $6 to $8 billion a year of viable drug products to avoid the risk of drug contamination. During a busy shift, it's easy to open a drug vial and then not have the chance to use it.

And the cost of drugs is just one part of the equation. You also need to consider the expense of needles, infusion bottles, and other consumables. Since you can't reuse or recycle these items, you need new supplies for every patient. While the cost for a single patient might be small, over the course of an entire year you could be spending thousands of dollars or more on these supplies. CSTDs are one effective way to solve this problem. The upfront cost of a CSTD may be more than a conventional syringe-needle approach. But when you consider that CSTDs can ensure drug sterility for up to 7 days, the cost savings quickly become apparent. In particular, by using a Simplivia CSTD, you can achieve as much as an 18% cost savings for healthcare systems through extended beyond use dating.

Chemotherapy agents and biologics are two high-cost drug types that frequently go to waste. Simplivia offers a CSTD product family that can help reduce these costs: Chemfort™. The Chemfort™ product family is cleared by the FDA under the ONB product code and is CE approved. Meeting the NIOSH definitions for CSTDs,Chemfort™ incorporates Simplivia’s patented Toxi-Guard® air-cleaning technology® for user safety when handling hazardous drugs. Chemfort™ also offers upgraded materials and improved usability.

Simplivia CSTDs have demonstrated substantial savings when used with chemotherapy drugs. Simplivia CSTDs have been show to provide an annual drug cost saving of 4% of the pharmacy budget. This can greatly reduce your overhead. Research estimates that the full cost of dispensing one dose of the chemotherapy drug fluorouracil averages US $932.93.3 That means you have the potential to save US $37.32 per patient, which adds up dramatically over the course of an entire year. These savings increase even further when you take into account biologic drugs. You may even be able to save up to 18.6% of your pharmacy budget every year.

There are a few ways in which these CSTDs can lead to such significant cost savings. First, they double the speed of drug compounding due to ease of use. Compounding time is cut by half when using Chemfort™ compared to other CSTDs like PhaSeal. From a productivity standpoint, this saves your staff time that they can devote to other tasks.

Another issue to consider is inventory. Traditional dispensing methods require having many supplies on hand that can be hard to keep track of in inventory systems. Simplivia CSTDs have a low number of SKUs, which reduces inventory requirements. This means you'll spend less on replacements, maintenance, and training. Looking at this practically, Chemfort™ can cut storage space in the cleanroom by 10%–15% and reduce your carrying cost by 5%.

It's not just about saving money on paper — CSTDs also protect workers, and that can save you the cost of a lawsuit. In conventional dispensation methods, healthcare workers can be exposed to hazardous substances that can put their health at risk. The CDC believes that about 8 million healthcare workers a year are exposed to hazardous drugs. These exposures can cause hair loss, infertility, and even genetic damage. One study found that occupational exposure to antineoplastic agents increased the rate of miscarriages and stillbirths.

These are the more drastic consequences — and this doesn’t even account for simple injuries like needle-sticks. Costs associated with needle-stick injuries amount to $199 to $1,691 per incident, with an average annual burden of $118 to $591 million. If your employees get hurt, the cost to your facility could be significant — both in lost time and lawsuits. It's becoming more and more common for healthcare workers to file claims when they aren't protected on the job.

Recently, a union filed a lawsuit against the US Occupational Safety and Health Administration on behalf of hundreds of thousands of healthcare workers. They did so because they claimed that the organization did not issue an infectious-disease protocol during the Covid-19 pandemic, putting their health at risk. Your organization can reduce your risk by implementing CSTDs to avoid a similar lawsuit.

Obviously, losing a seasoned staff member because they need to take some sick time puts a huge burden on your other workers, too. You'll have to spend additional time and expense training new staff to fill the missing employee's workload. CSTDs are an excellent way to protect staff. These closed systems ensure hazardous drugs can't come into contact with those handling them. Instead, drugs are prepared, handled and administered within the closed CSTD, so they go directly from the packaging into the patient without leakage or escape of drug vapors.

Additionally, you won't have to worry about needle-sticks, as the closed drug administration system eliminates any possible contact with the needle. A 2003 study examined the urine of healthcare workers who distributed antineoplastic agents. Before implementing CSTDs, many of them had these hazardous chemicals in their urine. After CSTD implementation, the number of workers who tested positive decreased. Consistent use of CSTDs can greatly reduce the chance of your staff suffering long-term harm from occupational handling of hazardous drugs.

It's easy to see how CSTDs can save you money due to extended beyond use dating and staff safety. But they also play an important role in preventing fines and penalties. There are a number of regulations in place requiring the use of CSTDs to keep healthcare workers safe. In particular, USP <800> went into effect in December, 2019, and mandates the use of CSTDs when handling hazardous drugs.

This isn't so much to protect pharmacists, who should already be using protective hoods and room venting, but the actual nurses and other personnel who distribute and administer the medications. Without a CSTD, drug vapors can escape and contaminate other healthcare professionals, patients and passersby. The penalty for not following this regulation can be severe. Each state has its own regulations, but potential punishments include losing your pharmacy license or hefty fines.

As you can see, CSTDs offer the potential for significant cost savings on prescription drugs and related supplies, especially with regard to chemotherapy and biologic drugs. They can also significantly increase healthcare provider safety, reducing the risk of injury and lawsuits. Finally, as USP <800> mandates the use of CSTDs, using them can help avoid exposure to legal liability. At Simplivia, we focus on innovation that delivers safety and confidence for healthcare professionals. Our Chemfort™ CSTD product family provides a complete portfolio of products for any handling protocol. 

When you choose a Chemfort™ CSTD for your drug handling needs, you're choosing both safety and meaningful cost savings. Contact Simplivia today to learn more about our CSTD products.