CHAPEL HILL – University of North Carolina at Chapel Hill’s Department of Pharmacy and the North Carolina Cancer Hospital have found a way to fight rising drug costs by implementing a waste reduction program that has cut costs $43 million a year. And the effort is receiving national attention.

The institutions received an “Innovator Award” from the Association of Community Cancer Centers (ACCC) at the 35th annual National Oncology Conference last week.

The awards, which have been given to forward-thinking cancer organizations at the national conference each of the last eight years, recognizes programs that have created new and innovative solutions to challenges that are commonly faced by cancer programs and practices.

Lindsey Amerine, the associate director of pharmacy at the UNC Medical Center in Chapel Hill, accepted the award from Tom Gallo, president of ACCC and the executive director of the Virginia Cancer Institute and Christian Downs, the executive director of ACCC, then explained her team’s efforts in a presentation at the conference.

UNC photo

Lindsey Amerine, PharmD, MS, associate director of pharmacy at the UNC Medical Center in Chapel Hill, accepts the award.

“Through drug vial optimization, our organization has decreased drug waste by 94 percent from 2011 to 2016, saving UNC millions of dollars in drug expenses annually,” Amerine said. “The drug waste reduction program has also decreased the number of closed-system transfer devices needed, due to fewer vials being opened, thus requiring fewer vial protectors.”

According to the UNC Medical Center, total medication costs in hospitals and clinics nationwide have increased by 49 percent from 2011 ($65.7 billion) to 2016 ($98.2 billion).  Oncology and infusion agents, including antineoplastics and biologics, are the largest drivers in this price increase.  Drug waste from the use of single-dose vials (SDV) for oncology and infusion agents is estimated to cost $1.8 billion annually.

In October 2011, UNC’s Department of Pharmacy implemented a drug vial optimization program, the first of its kind in the United States, according to the department.  Drug vial optimization is the extension of a drug vial’s sterility through the use of a closed-system transfer device – PhaSeal – up to the chemical stability of the drug or a maximum of 7 days, whichever is earlier.  The process has led to significant financial, safety, and clinical outcomes.

During the implementation of the drug vial optimization program, patient safety was a top priority, and it continues to be the medical center’s top priority while maintaining the program.  The measurement of central line-associated bloodstream infections (CLABSI) is an indirect marker for patient safety.  It is a sensitive measure that can be impacted by many activities such as handwashing.

“So the goal of our program was not to experience a CLABSI rate increase after implementation,” Amerine said.  “Instead, our CLABSI rate decreased following drug vial optimization implementation.”  The North Carolina Cancer Hospital was the first program in the nation to adopt a closed-system transfer device that has saved $43 million in drug expense annually by reducing waste.