Application of a new medicoeconomic evaluation tool for intravenous cytotoxic preparatoon
1 Unité de production des Anticancéreux, Institut Curie, 26 rue d’Ulm 75005 Paris
In 2019, the ARS set up a working group to develop a decision support tool to evaluate the economic interest of subcontracting the production of chemotherapy in hospitals. This medico-economic evaluation tool makes it possible to determine the unit cost of a intravenous (IV) chemotherapy by taking into account the various expenses related to this production: medical devices, staff, equipment, ..., but without the cost of the active substance. We tested this tool in order to evaluate the cost of automated production compared to manual production and to simulate the purchase of the most efficient robot.
For the years 2020, 2019 and 2017, the production data were extracted and analyzed, and then the different production costs were entered into the tool. It was used to obtain the cost of a IV cytotoxic preparation according to the different methods: manual, automated (PharmaHelp®) and general (manual + automated). The same work was done according to the robot systems available on the market. The comparison of the different years shows the impact on the cost per chemotherapy of new equipment (isolators) for manual preparation (from 30.98€ to 33.62€). For our automated system of maintenance and productivity in relation to the human resources mobilized (26.59€ in 2017 to 38.57€ in 2020). Finally, with the published pharmaceutical data and those of the manufacturers of existing automated systems, we were able to highlight the efficiency of this tool to compare equipment.
This tool demonstrates its sensitivity to determine the cost of a IV chemotherapy apply to the PharmaHelp® in 2017, which had high productivity but in 2020 had heavy maintenance that immobilized it for several months, The same goes for manual production with expensive equipment investments. This tool is also judicious to choose a new automated equipment in a more efficient way.