Background: The Australian Government spent over $1.5 billion on chemotherapy medicines under the Pharmaceutical Benefits Scheme (PBS) during the 2017–2018 financial year.1 At the Princess Alexandra Hospital (PAH), most parenteral cancer medicines (PCM) are manufactured in advance due to the time required to manufacture them; however this can lead to wasted doses. Reassigning unused PCM to another patient rather than discarding the dose, requires unremunerated pharmacy resources.
Aims: To determine how much the PAH saves the PBS annually by reassigning unused PCM, and to calculate the average time and staff cost to reassign a dose.
Methods: PCM reassignment was analysed over the period of 25th May 2018 to 25th May 2019. To determine the total amount saved by reassigning PCM during this time, usage reports were generated using local dispensing software to create a list of all reassigned doses of PCM. The amount saved was calculated by totalling the PBS ‘dispensed price for maximum amount’ for each medicine reassigned over the time period. A time-in-motion study and cost analysis of PCM reassignment was also carried out.
Results: Preliminary results show the PAH saves the PBS over $2.4 million annually by reassigning unused PCM which takes on average 10 minutes per medicine, equating to approximately $10 of labour cost.
Conclusions: The pharmacy staff-led waste minimisation strategy of PCM reassignment has positive financial outcomes for the Australian Government. Reimbursement to pharmacies reassigning PCM may provide an incentive to increase reassignment nationally, thereby contributing to the financial sustainability of the PBS. Further investigations into other pharmacy resource considerations (such as cost of storage for unused PCM) will further inform a proposed reimbursement fee. Once the final analysis is complete, the positive environmental impacts2 of reassigning PCM and the cost saving from the reassigned PCM not requiring incineration, will also be reported on.