Getting the most out of low-dose syringe prefilling of a high-cost biotechnology agent

The recent increased usage of high-cost biotechnology agents has placed a tremendous impact on the hospital pharmacy budget. One approach in improving cost containment is to minimize waste during the preparation of these agents. This is particularly practical and possible in the process of low-dose syringe repackaging of Sargramostim (GM-CSF) used for the treatment of neutropenia. In search of ways to reduce waste, this study looked into the dos and don'ts of repackaging this agent in syringes. Decreased waste is very significant if GM-CSF is properly reconstituted with bacteriostatic water for injection and if a syringe equipped with a permanently attached needle is used. Another 10% of the solution from each vial could be saved if the solution is withdrawn with a technique involving the vial in a right-side-up position.