When it comes to acquiring unit dose (UD) treatments, pharmacies at hospitals and long-term care facilities prefer to prioritize methods that are most likely to produce positive outcomes for their patients. The benefits of UD are well known; they provide patient safety enhancements, reduce waste, promote cost savings and enhance operational efficiency. Today, choosing the correct supplier when acquiring UD medications is vital in light of increasing budget scrutiny and decreased access to UD by many traditional industry suppliers.
Given that the Bar Code Medication Administration (BCMA) and the Drug Supply Chain Security Act (DSCSA) have changed the requirements for barcoded UD in recent years, it’s wise for facilities to question whether their current acquisition methods are most beneficial.
Fewer Manufacturers Currently Offering Barcoded Unit Dose
One solution is acquiring pre-packaged, barcoded UD that comes directly from the manufacturer. This can help mitigate several concerns facing in-house pharmacies, such as:
- Competitive bulk costs
- Liability issues
- Waste reduction and disposal management
- Lackluster efficiency processes
In recent years, however, many procurement professionals have found that pre-packaged UD providers are making fewer treatments available. This has resulted in increased burden on pharmacy staff to manage their own repackaging so they can ensure availability of the correct products for patients.
The Problem With In-House Repackaging
Packaging UD in-house from bulk medication can present problems. Besides the added work for staff, it increases the need to proliferate training programs and provide adequate infrastructure to support the education process. It also requires additional personnel to facilitate the labor of packaging internally, taking them away from their core competency of patient care.
In-house repackaging also requires a substantial capital investment in both equipment and the bulk product itself — which may become waste if it’s not dispensed. In addition, repackaging medications in the hospital shortens their expiration date and leads to an increase in unusable inventory. These factors may not be factored in during initial cost analysis, but they all impact the bottom line and, more importantly, the ability to efficiently care for patients.
Inconsistent Access and Service Times From Third-Party Repackagers
Hospitals may determine that it’s advantageous to outsource UD procurement. While many frequently-dispensed treatments are available commercially prepackaged in UD, there are instances in which UD is not accessible and alternative methods may be required to obtain product. One such alternative is to partner with a third-party repackager. While this method can remove burden from pharmacy staff and lighten the strain on internal resources, it presents significant drawbacks.
When third parties repackage medication, it’s the hospital’s responsibility to acquire bulk product to provide to the repackager. The hospital must also negotiate potentially complex packaging instructions to the facility. In addition, the hospital is at the mercy of the repackager and may be subjected to low service levels and lengthy turnaround times for with the return of their repackaged product.
All of this introduces supply issues. If a third-party repackager requires weeks to return a high-utilization item, the pharmacy may run out before then. This prevents pharmacy from being able to facilitate its preferred method of care and may force it to explore alternative treatments in an emergency situation.
Unit Dose Manufacturers Provide a Safe, Reliable and Cost-Effective Solution
A UD manufacturer presents a more practical option that provides solutions to the problems presented by in-house packaging and thirdparty repackagers.
First, there is no need to produce bulk. Since UD is made available in right-sized cartons, pharmacies can order what they need based on anticipated usage. Additionally, consistent supply of UD across distribution centers and access through numerous industry ordering platforms (such as PRxO Generics) guarantees a hospital’s ability to acquire treatments in a matter of days, not weeks. Safety features provided by prepackaged UD — such as “Tall Man” lettering and blisters with enhanced legibility — provide additional security over alternative procurement methods. Finally, removing pharmacy from the repackaging process mitigates its liability and provides safety, efficiency and budgetary benefits while promoting prompt access to care for patients.
In today’s world of ever-spiraling medical costs, the idea of a reliable barcoded UD provider may sound too good to be true, let alone one that guarantees a robust product portfolio, broad access and consistent supply. But by obtaining products from a UD manufacturer, pharmacy buyers and procurement specialists can still access the treatments they need despite the recent exodus of UD providers from the marketplace.
The result is increased patient safety and pharmacy efficiency while simultaneously limiting costs and freeing up staff to focus on what they do best — taking care of patients.