Improving Efficiency and Safety with Prefilled Syringes: A Model-Based Economic Evaluation for US Healthcare Settings

Prefilled syringes provide an opportunity to improve clinical safety and operational efficiency in hospital settings, especially amid mounting and ongoing challenges such as staff shortages, escalating drug costs, and increasing importance of safe medication administration. Despite these potential benefits, adoption remains limited. This study develops an economic model to assess the clinical and financial impacts of switching from conventional vial-and-syringe methods to prefilled syringes in United States (US) hospitals' intensive care units (ICU).

To address the gap between the potential benefits of prefilled syringes and their limited adoption, an economic model was developed to help decision-makers make informed choices based on the clinical and financial impact of switching to prefilled syringes in US ICUs. The model used peer-reviewed literature and hospital practices around the most utilized dosages in a US hospital. To illustrate model utility, three hypothetical ICU cases were developed: administering 30 daily doses of atropine 1mg/10mL, epinephrine 1mg/10mL, and ephedrine 25mg/10mL. Sensitivity analyses were performed to test model robustness.

Switching to prefilled syringes resulted in annual cost savings of $729,912 for atropine, $786,502 for epinephrine, and $709,772 for ephedrine. The model estimated annual savings to be $696,551 due to fewer pADEs, along with savings of $53,411, $89,744 and $50,244 annually, due to unused drug wastage reduction for each drug, respectively. Hospital staff preparation time decreased by 255 hours for atropine, 285 for epinephrine and 227 hours for ephedrine per year. Sensitivity analyses confirmed the robustness of the model by varying drug wastage rates, with potential savings of up to $740,443, $795,894 and $724,757 for each drug, respectively, showing the model's adaptability across different ICU scenarios.

This model suggests prefilled syringes may help hospitals address pharmacy operational challenges by reducing preparation time, drug wastage, and pADEs. They offer a practical approach to support safer and more efficient medication delivery in clinical settings.