They enhance patient safety and streamlining pharmacy operations. In recent years, however, some manufacturers have made fewer treatments available in barcoded unit dose. This trend has placed an increased burden on pharmacy staff to either manage their own repackaging or partner with third-party repackagers to ensure products are available for caregivers. At the same time, pharmacy leaders must continue to comply with Bar Code Medication Administration (BCMA) and Drug Supply Chain Security Act (DSCSA) requirements that enhance patient safety and drug traceability for barcoded UD.
With increasing pressure to work more efficiently while facilitating the highest quality care, health system pharmacies are seeking new ways to create cost efficiencies in their purchasing operations. One way to do this is to examine current UD acquisition methods to determine whether they deliver optimal value. When performing cost analyses of UD acquisition options, a health system pharmacy must look deeper than cost per dose. Many factors related to UD sourcing decisions impact the bottom line and, just as importantly, the ability to efficiently care for patients.
Is it time to rethink your unit dose acquisition strategy?
Finding the Right Fit
When evaluating whether to handle unit dose repackaging in-house, work with a third-party repackager or purchase commercially available unit dose products, buyers must carefully consider the full value for each strategy. While, in many cases, it may appear to be more cost-effective to purchase bulk product and repackage it in-house, the total cost of this approach must be considered, including labor, equipment, packaging materials and the time required for the technicians to repackage medications. Further, when looking at third-party repackagers, pharmacies must continually evaluate access and service times.
As health system pharmacy budgets continue to tighten, choosing the correct supplier for pre-packaged UD is vital. A UD provider that offers a rich product portfolio, broad access and consistent supply can be a cost-effective solution for obtaining barcoded, ready-to-scan medications for caregivers.
Rethink: In-house Repackaging
Many health systems choose to handle repackaging in house, believing this method to be the most cost-effective approach to UD acquisition. However, besides the added work for staff, insourcing unit dose packaging increases the need to develop training programs and provide adequate infrastructure to support the education process. It also consumes significant human resources to facilitate the packaging process, taking pharmacists and technicians away from higher value, patient-centric activities. Pharmacists often report patient counseling and care to be activities that they feel they should spend more time on, yet they are often so burdened by pharmacy tasking that they cannot focus on their core competencies.
In-house repackaging also requires a substantial capital investment in both equipment and maintenance, as well as bulk product itself – which may become waste if it is not dispensed. In addition, repackaging medications in the hospital shortens their expiration date and leads to an increase in unusable inventory. Managing in-house repackaging can also create space issues with the extensive equipment and physical space required for packaging operations.
Further, the potential for errors inherent in the manual repackaging process could put the hospital, clinicians and patients at risk. Packaging in the hospital setting places a legal burden of accuracy in packaging and dispensing on hospital associates and dispensing caregivers. If a patient has an adverse reaction to a medication because of an in-house labeling error, for example, the liability falls squarely on the hospital’s shoulders. Packaging UD in the hospital setting can also create inefficiencies at the point of care. In-house barcodes may have scannability problems, requiring clinical staff to develop a workaround solution to get the medication to the patient. In-house equipment may produce low-quality labels that can cause problems for automated dispensing machines and make it difficult to count inventory. During an initial cost analysis, all of these factors must be considered because of their impact to the bottom line and the ability of a facility to care for patients efficiently.
Rethink: Third-party Repackaging
Some hospitals and health systems choose to outsource repackaging to a a third party in an attempt to avoid costly investments in internal repackaging. But outsourcing presents a number of drawbacks as well.
For starters, the logistics of managing the outsourcing company can be substantial and time-consuming for pharmacy departments whose labor resources are already stretched thin. There are added costs to consider as well, such as shipping charges, upcharges for special packaging materials and a la carte product pricing structures.
When third parties repackage medication, it is the hospital’s responsibility to acquire bulk product and provide it to the repackager. The hospital must also communicate potentially complex packaging instructions to the repackager. Further, the hospital may be subject to low service levels and lengthy and unpredictable turnaround times for receiving repackaged product. This could potentially cause a pharmacy to run out of a high-utilization item before a shipment arrives from the repackager.
Rethink: The Value of Commercially Available Unit Dose
As health systems work to ensure patients receive cost-effective, high-quality medications, partnering with a unit dose manufacturer can deliver more value and eliminate the problems presented by in-house repackaging and third-party repackagers. First, there is no need to obtain bulk. Since UD is made available in right-sized cartons, pharmacies can order what they need based on anticipated usage. Stability testing of prepackaged UD products supports dating of up to 24 months. Partnering with a UD manufacturer also allows a health system to further reduce waste by enabling it to stock necessary, but low-volume-utilized medications in UD format. This enables the system to meet the clinical needs of care providers while lowering waste associated with expiration of excess inventory.
Using manufactured UD also eliminates the need for a robust packaging infrastructure within the hospital. As a result, equipment needs are reduced and less packaging material is required. Not only does this free up an expense line in the budget, it also frees up floor space within the hospital.
Removing pharmacy from the repackaging process also mitigates its liability and provides safety, efficiency and budgetary benefits. Purchasing as many medications as possible in pre-packaged, barcoded UD format allows staff to be redeployed to more patient-centric activities than packaging medications. As highlighted previously, this often falls right in line with pharmacists’ desired operational demands.
Partnering with a UD manufacturer dedicated to supplying serialized, barcoded UD products using state-of-the-art production equipment is an optimal solution for health systems and LTC pharmacy. This means pharmacies benefit from crisp, scannable barcodes and easy-to-open packaging – providing customers with greater value that enables staff to spend more time focused on patients.
The Benefits of Partnering With a UD Manufacturer
The right UD manufacturer partner provides a wealth of benefits:
- Broad and growing product portfolio spanning all therapeutic classes
- Inclusion across all major GPOs
- Stability testing to support 24-month dating
- Consistent product supply
- Serialized, barcoded packaging
- Color-coded labels and tall-man lettering to support safety
- Experts dedicated to commercially available unit dose products
- State-of-the-art packaging and labeling equipment
- Regulated by the FDA and adheres to cGMP
About American Health Packaging
American Health Packaging’s products support the bedside point-of-care and operating efficiency initiatives for health systems and LTC pharmacy. With products serialized and barcoded to the dose level and nearly 500 SKUs across all major therapeutic classes, we are the leading provider of unit dose oral solids in the healthcare marketplace. Many of our products are industry exclusives – available only from American Health Packaging. In 2017, AHP introduced Liquid Unit Dose cups, broadening our commitment to patient safety through a new oral liquids offering. Our products are stocked by partner GPOs and industry wholesalers to ensure purchasing compliance for pharmacy buyers and other procurement specialists.