Standardisation du coût des préparations injectables de médicaments cytotoxiques et antiviraux injectables en unité centralisée

Three thousands injectable cytotoxic drug preparations (infusion bags and syringes) are made each year in the pharmaceutical department of Robert Debré Hospital. Centralization of preparations requires both specific equipment and qualified staff members, thus resulting in increasing the cost of manufacturing. The objective of this study was to evaluate the cost of the preparation depending on its conditioning : syringe or infusion bag. As many aspects as possible were taken into account : cost covering drug, required material, personal, maintenance and investments. The costs of 694 chemotherapic drug preparations handled between January and March 2005 were separately calculated. The little costs' variation was compatible with a standardization of the calculation. Preparations were classified according to their final conditioning : infusion bags, 1 mL syringes and other syringes. The average cost of a preparation - excluding the costs of the drug itself and the act of reconstitution of lyophilized compounds - was determined for each final conditioning : amounts were 27.15, 25.55 and 28.35 euros for infusion bags, 1 mL syringes and other syringes, respectively. The costs of the drug itself and the reconstitution process were added to this amount: their value depends on the quantity of drug used for the preparation. This way of calculation could be applied to determine the cost of cytotoxic drugs' preparations. Further studies are needed to assess the possibility to use this method in other hospitals especially non pediatric establishments.