Cost-effectiveness of Two Technology-assisted Manual Medication Picking Systems Versus Traditional Manual Picking in a Hospital Outpatient Pharmacy

Overview

Journal Eur J Hosp Pharm

Publisher BMJ Publishing Group

Specialty Pharmacy

Date 2021 Feb 20

PMID 33608438

Authors

Marcus Eng Hwa Teo

Bih Yee Chia

Yeng Ching Lee

Pearlyn Li Ying Tay

Jane Ai Wong

Soo Boon Lee

Mun Moon Lim

Mcvin Hua Heng Cheen

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the cost-effectiveness of two technology assisted manual medication picking systems vs traditional manual picking.

Methods: This was a retrospective observational study comparing three outpatient pharmacies of a tertiary referral hospital in Singapore, where a light-emitting diode (LED-guided) manual picking system, an LED-guided manual picking plus lockable drawer (LED-LD) system, and traditional manual picking were implemented, respectively. The primary outcome measure was the incidence of medication near-misses over the observation period. The incremental cost-effectiveness ratio (ICER) per near-miss avoided was also determined. Data on medications picked and near-misses reported between September 2017 and June 2018 were retrieved from electronic databases. The incidence of medication near-misses from the LED-guided and LED-LD systems, relative to traditional picking, was compared using logistic regression. We compared annual operating costs between manual medication picking systems, and reported ICERs per near-miss avoided, to evaluate the cost-effectiveness of each picking system.

Results: A total of 358 144, 397 343 and 254 162 medications were picked by traditional manual picking, LED-guided and LED-LD systems, respectively. The corresponding near-miss rates were 8.32, 4.08 and 0.69 per 10 000 medications picked, respectively. Medication near-miss rates were significantly lower for the LED-guided (OR 0.49, 95% CI 0.40 to 0.59, p<0.001) and LED-LD systems (OR 0.08, 95% CI 0.05 to 0.13, p<0.001) compared with traditional picking. The annual operating costs of traditional picking, LED-guided and LED-LD systems were S$60 912, S$129 832 and S$152 894, respectively. The LED-guided and LED-LD systems yielded ICERs of S$189 and S$140 per near-miss avoided, respectively, compared with traditional manual picking.

Conclusion: The LED-LD system is more cost-effective than both the LED-guided and manual medication picking systems in reducing medication picking near-misses.

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