A Cost-Effectiveness Study Comparing Ready-to-Administer and Traditional Vial-and-Syringe Method for Opioids

The purpose of this study was to develop a cost-effectiveness model for manufacturer-prepared prefilled ready-to-administer (RTA) syringe products versus the traditional vial-and-syringe administration of intravenous (IV) opioids.

Cost parameters included cost of manufacturer-prepared prefilled RTA syringe product, traditional vial and syringe, drug preparation, drug administration, drug waste, and severity of error. Effectiveness endpoint included number of preparation and administration errors in each comparator arm. Simple decision tree was used, and incremental cost-effectiveness ratio (ICER) was calculated as the reduction in the incremental errors per observation with RTA compared with traditional vial-and-syringe method. One-way sensitivity analysis (OWSA) and probabilistic sensitivity analysis (PSA) were conducted to test the robustness of the model. TreeAge Pro software was used to create and analyze the decision model. All the cost parameters were converted to USD 2021.

Base-case analysis showed that the cost of the RTA arm was lower by $182.61 and the number of errors in the RTA arm was lower by 94%, compared with the traditional vial-and-syringe arm. The manufacturer-prepared prefilled RTA syringe product was found to be cost-effective with an incremental savings of $22,554 per additional error avoided. Sensitivity analysis showed that ICER value was most sensitive to the probability of errors; however, the results were robust in showing that RTA is the preferred cost-effective option, when both the costs and effectiveness parameters were varied substantially.

This economic evaluation  analyzed costs of using manufacturer-prepared prefilled RTA syringe product IV opioids and incremental benefits in terms of reduced errors, adverse events, and their associated costs. Manufacturer-prepared prefilled RTA syringe product was found to be cost-effective, demonstrating cost savings by reduction in the error rates. Integrating and adopting RTA syringe products within a health system could play an important role in improving care, building efficiency, increasing patient safety, and saving money.