Ready-to-use pre-filled syringes of atropine for anaesthesia care in French hospitals - a budget impact analysis

Abstract

Background: Patient safety is improved by the use of labelled, ready-to-use, pre-filled syringes (PFS) when compared to conventional methods of syringe preparation (CMP) of the same product from an ampoule. However, the PFS presentation costs more than the CMP presentation.

Objective: To estimate the budget impact for French hospitals of switching from atropine in ampoules to atropine PFS for anaesthesia care.

Methods: A model was constructed to simulate the financial consequences of the use of atropine PFS in operating theatres, taking into account wastage and medication errors. The model tested different scenarios and a sensitivity analysis was performed.

Results: In a reference scenario, the systematic use of atropine PFS rather than atropine CMP yielded a net one-year budget saving of €5,255,304. Medication errors outweighed other cost factors relating to the use of atropine CMP (€9,425,448). Avoidance of wastage in the case of atropine CMP (prepared and unused) was a major source of savings (€1,167,323). Significant savings were made by means of other scenarios examined. The sensitivity analysis suggests that the results obtained are robust and stable for a range of parameter estimates and assumptions.

Study limitations: The financial model was based on data obtained from the literature and expert opinions.

Conclusion: The budget impact analysis shows that even though atropine PFS is more expensive than atropine CMP, its use would lead to significant cost savings. Savings would mainly be due to fewer medication errors and their associated consequences and the absence of wastage when atropine syringes are prepared in advance.

Keywords: Anaesthesia; Atropine; Budget impact analysis; Conventional methods of preparation (CMP); Health economics; Pre-filled syringes (PFS); Ready-to-use intravenous drugs.