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How to choose an automatic compounding system for preparing cytotoxic drugs ?
European Statement
Production and Compounding
Why was it done?
Different automated production systems (APS) are now available on the market. It is essential not to make a mistake due to the impact on the organization, investments and architecture. Comparative tables of each equipment are not enough to properly make a good choice.
What was done?
We determined a decision tree to choose the most suitable equipment for the cytotoxic drugs production unit.
How was it done?
Based on our experience of using APS and interviews or visits of other users of the equipment, we have compared the different systems by classifying them according to the items that are the most efficient: productivity, precision, diversity of preparations and drugs, installation constraints, autonomy, maintenance of sterility of preparations, chemical contamination. We also used a French calculator, published by the ARS IDF, to determine the cost of a preparation, taking into account the purchase price, personnel, consumables, maintenance, personnel equipment, and operating costs. Then we defined our present and future needs (dose banding, nominative advance preparation, type and quantity of preparation (infusers, syringes, bags), architectural and air treatment constraints. Then we classified the needs and constraints by importance and then determined for each one which equipment was the best answer.
What has been achieved?
We classified the needs and constraints by importance and for each one we determined which equipment was the best answer. From most important to least we had: headroom, floor load, air handling, dose banding, sterility maintenance, productivity, autonomy and calculated price of the preparation. The results for preparation price showed that the highest price per preparation is not the most expensive equipment but one of the cheapest because of the very expensive captive consumables. Unexpectedly, the most expensive equipment has an average price per preparation because it is very productive, autonomous and has few captive consumables. To validate this tree, we applied it to another cytotoxic production unit.
What next?
Using this decision tree, the choice of equipment will be the most suitably adapted for each hospital.