Cost analysis of using premixed frozen versus hospital-reconstituted cefazolin sodium injection

The costs of preparing cefazolin sodium 1-g small-volume injections (SVIs) by each of two reconstitution methods were compared with the costs of using premixed frozen cefazolin SVIs at two hospitals. Both hospitals routinely used premixed cefazolin 1-g SVIs. Each converted to its previous reconstitution system for approximately two weeks. One hospital used a once-weekly "batch" system, and the other hospital used the twice-daily "extemporaneous" system. Pharmacist and technician time involved in both systems was determined using time-and-motion methods. A total of 40 preparation cycles of 10 SVIs each were monitored to determine labor costs. Hospital purchase-contract prices were used for determining material costs per SVI, and waste was calculated based on the number of SVIs that could not be recycled. The total time required for preparation of 10 cefazolin 1-g SVIs by each method was comparable (6.2 minutes for the batch method, 5.8 minutes for the extemporaneous method); labor costs contributed minimally to overall costs of each reconstituted SVI. Approximately 5% of reconstituted SVIs were wasted in each system. The conversion to premixed cefazolin SVIs resulted in an annual cost increase of more than $5000 at each hospital, compared with the reconstitution methods. However, subjective evaluations indicated that use of the premixed admixtures resulted in increased efficiency of i.v. preparation by allowing pharmacy personnel to devote more time to other labor-intensive duties. The results of this study allowed the pharmacies to negotiate more equitable prices for premixed cefazolin sodium injection.(ABSTRACT TRUNCATED AT 250 WORDS)