Preparation Times and Estimated Costs for Vancomycin Formulations: Does the Difference Matter?

Area of Science:

• Pharmaceutical Sciences
• Infectious Diseases
• Healthcare Management

Background:

• Long-term care facilities (LTCFs) increasingly manage infections caused by methicillin-resistant Staphylococcus aureus (MRSA).
• Sterile vancomycin for intravenous administration presents high pharmaceutical costs for LTCF pharmacies.
• Cost-effective medication provision is critical for managing drug-resistant organisms in LTCFs.

Purpose of the Study:

• To compare the pharmaceutical costs of vancomycin preparations in a long-term care pharmacy.
• To evaluate preparation times for outsourced, compounded, and room temperature premixed vancomycin formulations.
• To identify cost-effective strategies for vancomycin administration in LTCFs.

Main Methods:

• Retrospective observational study of 124 vancomycin orders.
• Comparison of total pharmacy preparation time and pharmacist labor time for three vancomycin formulations.
• Cost calculations based on ingredient costs and national median pharmacist labor costs.

Main Results:

• Room temperature premixed vancomycin exhibited the shortest mean preparation times.
• Total pharmacy costs were lowest for premixed vancomycin ($809.36), followed by compounded ($993.94), and outsourced ($2220.34).
• Mean preparation time over a full course of treatment was 2 hours 8 minutes for premixed versus 5 hours 3 minutes for compounded vancomycin.

Conclusions:

• Room temperature premixed vancomycin offers reduced preparation times compared to compounded and outsourced options in skilled nursing facilities.
• Cost-effective medication provision is essential for LTCFs managing complex infections.
• Premixed vancomycin presents a viable, economical alternative for intravenous administration in long-term care settings.