The True Price of Prefilled Syringes

Running a lean and mean surgical facility is more important than ever during COVID-19, so why should you buy premixed and prelabeled syringes from a compounding pharmacy when they're more expensive than the medications you draw-up and label in-house? Because putting too much of an emphasis on the going rates of your commonly used medications could cost you more down the road. Before writing off prefilled syringes, consider what you're actually getting for the price. You might find out it makes perfect sense (and cents) to go the readymade route.

The use of prefilled syringes isn't an all-or-nothing proposition. For some drugs — such as medications that cost less than $10 per dose in standard vials and twice that amount in prefilled syringes — you might be willing to pay extra for the convenience of not having to dilute and label the medications before administering them. That calculus changes for medications that normally cost $200. Paying twice that amount to receive the agents in prefilled syringes might not be worth it.

"My advice for purchasing prefilled syringes is advice that applies to anything — you can't take a blanket approach," says Merlin Wehling, MD, a board-certified anesthesiologist and the director of anesthesia at Kearney (Neb.) Regional Medical Center. "You need to make a data-driven case for spending more."

He suggests gathering the exact dollar amounts you spend on commonly used drugs to determine the direct costs of preparing and administering medications while also considering a variety of factors that could lead to soft savings:

• Time. You shouldn't opt for prefilled syringes simply because they're convenient and your staff doesn't feel like diluting and labeling medications. But in many cases that convenience translates directly into significant savings. The time spent setting up, diluting, drawing and labeling medications is money — especially for busy outpatient centers where shaving precious minutes off turnover times can lead to additional cases.

"If your anesthesia providers spend a minute or two preparing drugs, and your goal is sub-20-minute turnover times, prefilled medications can be a difference-maker," says Dr. Wehling.

• Safety. The outpatient surgical environment is built on a culture of speed and efficiency — factors that can increase the risk of medication errors involving potent drugs with specific dosage and usage requirements. Medication errors are rare but catastrophic when they do occur, says Allen J. Vaida, BSc, PharmD, FASHP, executive vice president at the Institute for Safe Medication Practices (ISMP).

"A high-profile incident will cost you a lot of money [in legal fees] and subject your facility to bad publicity," says Dr. Vaida. He remembers a case involving a patient who was under general anesthesia and had his knee injected with epinephrine from an unlabeled syringe, which providers mistakenly thought was filled with a local anesthetic. The patient went into pulmonary arrest and ultimately died because of the error. Many drug administration mistakes occur because anesthesia providers are tasked with drawing medications into syringes and labeling them with no oversight in place, according to Dr. Vaida.

If you're not yet ready to make the move to prefilled syringes, keep an eye on the market. You may have a change of heart because competition is steadily driving costs down. "Prefilled syringes are still more expensive than standard vials, but they don't cost nearly as much as they did five or six years ago," says Dr. Vaida. When you combine decreasing costs with the time-savings and increased safety associated with prefilled syringes, a strong case can be made for transitioning to the convenient and cost-effective option in drug administration. OSM