Microcosting method for small-volume injectables

The costs of preparing different small-volume injectables (SVIs) in a centralized i.v. admixture pharmacy in a 650-bed teaching hospital were calculated using a microcosting method. The types of SVIs produced and methods of preparation were identified. Time-and-motion and work-sampling studies were performed to determine the amount of pharmacist and technician time spent in SVI production, auxiliary activities, and nonproductive activities. The costs of material and equipment used were calculated, and waste-cost factors based on percentages of wasted SVIs were determined. To determine the final cost per unit prepared, the calculated costs were added and multiplied by the appropriate waste factors. On the average, it took 5.57 minutes of total personnel time to prepare an SVI. It took an average of 192.4 seconds and 16.6 seconds for the technicians and pharmacists, respectively, to reconstitute a vial of powder and prepare an SVI in a minibag. Bulk prepacked items and admixtures prepared from vials of powder for reconstitution and stored in minibags were, respectively, the least and most expensive SVIs. By using microcosting methods to determine the cost of preparing SVIs, this institution discovered that the cost figures were much higher than it had anticipated. These data can be used to improve productivity and cost efficiency and to compare the costs of in-house and commercially available preparations.