Manual, cobotic, or semi-automated: which preparation mode for our 5-FU infusors?

Introduction
5-FU elastomeric infusor production represents a high-volume, repetitive activity in our centralized preparation unit, which supplies a day unit organized around disease-specific scheduling, where patients are grouped by cancer type on a given day. Automation is already part of our practices but has shown, in retrospect, insufficient productivity for this specific activity, while other market solutions offer so-called hybrid semi-automated systems. This study aims to compare the productivity of the different production modes, as well as the associated consumable costs for 5-FU infusor preparation, in order to consider implementing a semi-automated device.

Material and method
In this study, we compare manual production under a Biological Safety Cabinet, cobotic production (Apoteca-Chemo^®), and semi-automated production (Mibmix^®) across production runs of standard-dose 5-FU infusors. Preparation times (in minutes) were extracted from Drugcam^® software (manual), Apoteca Manager^® software (cobot), and by timed measurement for the semi-automated device. Pre-tax consumable costs specific to infusor manufacturing for each production mode are based on current procurement contracts.

Results
Preparation times (mean ± CV) were as follows: manual 4.40 ± 0.91 min (n = 3,418); Apoteca Chemo^® 10.80 ± 1.52 min (n = 3,470); MibMix^® 2.49 ± 0.40 min (n = 40). Consumable costs per infusor amounted to 0.60€ for manual preparation and 2.15€ for the cobot.
For the semi-automated device, cost varies depending on batch size N, since three consumables are shared across N preparations: filling tubing, two 50 mL syringes, and a 20 mL product purge volume. Therefore the total cost follows the formula 0.37 + (32.80/N) for N infusors.

Discussion – Conclusion
MibMix^® appears to be the most productive preparation mode: it is twice as fast as the manual technique and four times faster than the cobot. For a typical batch of 60 infusors scheduled on a single day, total production time is 2.5 hours with MibMix^®, versus the current 10.8 hours with automated production.
The consumable cost for this same 60 infusors batch is 0.92€ per infusor with MibMix^® (55.20€ in total), compared to 36.00€ manually and 129.00€ with the cobot. Manual preparation remains the least expensive in terms of consumables but exposes staff to repetitive movements with a risk of musculoskeletal disorders, a major concern for series production.
The cobot has the longest cycle time but minimizes direct manual handling to the greatest extent. The semi-automated device is a more productive solution, becoming more cost-effective than our currently used cobot from a batch size of 19 infusors onward. Given the volume of our activity, implementing the Mibmix^® semi-automated device in our production processes appears relevant, although the required investment and scope of applications still need to be assessed.

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