内容紹介
Summary
At Ogaki Municipal Hospital, we expanded the preparation of anticancer drugs using a closed system drug transfer device(CSTD)when revising medical fees in 2016. In this study, we investigated the number of regimens and number of preparations for outpatients in December 2017. Subsequently, the cost of all consumables related to the preparation of anticancer drugs was calculated. In total, 574 preparations of 68 regimens were conducted, with CSTD used in the preparation of 331(57.7%)drugs. The cost associated with preparation of anticancer drugs was 1,608,163 yen/month, of which the CSTD cost was 1,135,315 yen/month(70.6%). Given the disproportionately high cost related to CSTD, we investigated for material cost reduction. Although CSTD has a mechanism for adjusting the differential pressure inside and outside the vial, the conditions were used to calculate medical fee; however, if we use what we do not have, we estimated that the facility burden would be reduced by 24.7%. CSTD can contribute not only to safety through exposure prevention but also to medical cost reduction through introduction of“Drug Vial Optimization.”We believe it will continue to act as a medical evidence to reduce medical fee remuneration and ease the conditions of fee calculation.
要旨 大垣市民病院では,平成28年度診療報酬改定を機に閉鎖式薬物移送システム(closed system drug transfer device: CSTD)を用いた抗がん薬調製業務を拡大した。今回,2017年12月の当院外来患者のレジメン数,調製件数を調査し抗がん薬調製にかかわる全消耗品の費用を算出した。抗がん薬調製68レジメン,調製件数574件,CSTDの使用は331件(57.7%)であった。抗がん薬調製にかかわる費用は1,608,163円/月であり,そのうちCSTDの費用は1,135,315円/月(70.6%)であった。CSTDにかかわる費用は非常に大きいため,材料費削減の検討を行った。CSTDはバイアル内外の差圧を調節する機構を有することが診療報酬算定条件であるが,有しないものを使用した場合施設負担額は24.7%削減と試算できた。CSTDは曝露防止の安全面のみではなく,drug vial optimization(DVO)導入による医療費削減にも貢献でき,今後も診療報酬の改定や算定条件の緩和に向けて,医療現場からエビデンス作りを行っていきたいと考える。
目次
At Ogaki Municipal Hospital, we expanded the preparation of anticancer drugs using a closed system drug transfer device(CSTD)when revising medical fees in 2016. In this study, we investigated the number of regimens and number of preparations for outpatients in December 2017. Subsequently, the cost of all consumables related to the preparation of anticancer drugs was calculated. In total, 574 preparations of 68 regimens were conducted, with CSTD used in the preparation of 331(57.7%)drugs. The cost associated with preparation of anticancer drugs was 1,608,163 yen/month, of which the CSTD cost was 1,135,315 yen/month(70.6%). Given the disproportionately high cost related to CSTD, we investigated for material cost reduction. Although CSTD has a mechanism for adjusting the differential pressure inside and outside the vial, the conditions were used to calculate medical fee; however, if we use what we do not have, we estimated that the facility burden would be reduced by 24.7%. CSTD can contribute not only to safety through exposure prevention but also to medical cost reduction through introduction of“Drug Vial Optimization.”We believe it will continue to act as a medical evidence to reduce medical fee remuneration and ease the conditions of fee calculation.
要旨 大垣市民病院では,平成28年度診療報酬改定を機に閉鎖式薬物移送システム(closed system drug transfer device: CSTD)を用いた抗がん薬調製業務を拡大した。今回,2017年12月の当院外来患者のレジメン数,調製件数を調査し抗がん薬調製にかかわる全消耗品の費用を算出した。抗がん薬調製68レジメン,調製件数574件,CSTDの使用は331件(57.7%)であった。抗がん薬調製にかかわる費用は1,608,163円/月であり,そのうちCSTDの費用は1,135,315円/月(70.6%)であった。CSTDにかかわる費用は非常に大きいため,材料費削減の検討を行った。CSTDはバイアル内外の差圧を調節する機構を有することが診療報酬算定条件であるが,有しないものを使用した場合施設負担額は24.7%削減と試算できた。CSTDは曝露防止の安全面のみではなく,drug vial optimization(DVO)導入による医療費削減にも貢献でき,今後も診療報酬の改定や算定条件の緩和に向けて,医療現場からエビデンス作りを行っていきたいと考える。