SELECTING AND ALLOCATING REPACKAGING TECHNOLOGY FOR UNIT-DOSE MEDICATIONS IN HOSPITAL PHARMACIES

To increase patient safety and support bedside-point-of-care medication administration, millions of unit-dose medications are dispensed in hospitals and health systems daily. Because not all medications are available in unit-dose form directly from the manufacturer, hospitals must repackage medications in unit-dose form themselves. We develop a mathematical model that simultaneously determines which level of technology is warranted and how each medication that is not delivered to the pharmacy in unit-dose form should be repackaged subject to multiple constraints. This model has been integrated into a free Excel-based tool available to pharmacy directors. We test our model with data based on small, medium, and large hospitals and conduct sensitivity analyses to gain further insight. We illustrate how the results from our model can aid in incorporating qualitative aspects into technology selection. Our results show that a semi-automated repackaging system is the most economical technology alternative for most hospital pharmacy in-house repackaging operations. This result, however, is sensitive to the number of unit-dose medications to repackage and the available labor.