A P R I L 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 6 1
consider the time and
waste they save. They can
also take up more space in
storage — an issue for facil-
ities dealing with tight quar-
ters. Additionally, you may
not be able to — or want to
— get every drug you need
from an FDA-inspected
503B compounder. Some
compounder drugs — like
propofol — have much
shorter shelf lives than the
drugs you get from pharma-
ceutical providers. But
when you consider all the
factors, including, by the
way, the vast improvement
in FDA oversight of com-
pounders that's come about
in the last few years, pre-
filled and pre-packaged
meds are clearly an idea
whose time has come.
OSM
pharmacy consultant to develop an accurate cost analy-
sis, based on what you're doing now vs. what you might
consider going forward. That means looking at more
than just the obvious. For example, now you have to buy
drugs, you have to buy needles and syringes, you have
to buy labels, and you probably have to buy small IV
bags to put drugs in. And then there are the costs relat-
ed to extra time — with both nurses and anesthesia
providers. Those may not be as easily identifiable, but
they're interrupters. Consider also the temptation that
exists to bend the rules. A busy facility may decide to
mix drugs well in advance, instead of doing so on an
as-needed basis, as close to administration time as
possible. It pays to eliminate that temptation.
Ultimately, when you look at all of those costs, and
consider, too, that some compounders' prices may be
negotiable and have group purchasing structures, the
price gap may really narrow. Pre-filled meds may still
be a little more expensive, but there are more factors to
consider — the cost of having something go wrong in
terms of patient and family impact, legal costs, costs
to your reputation or maybe the cost of an injured staff
member. That may be all the discussion you need
before deciding on this extremely important quality-
assurance measure.
— Sheldon S. Sones, RPh, FASCP
Mr. Sones (shelsones@aol.com) is a
pharmacy and safe medication consult-
ant to surgical centers, and a member of
the Outpatient Surgery Magazine editorial
board.
Dr. Vitcov (stevevit-
cov@gmail.com) is the
medical director of the
Presidio Surgery Center
in San Francisco, Calif.
