Cost-effectiveness analysis of a unit dose dispensing robot in Thailand
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Keywords
cost effectiveness analysis, Medication errors, unit dose dispensing robot
Abstract
Background: Medication errors can lead to serious consequences, including adverse drug events and even death. To reduce medication errors, many hospitals have implemented medication-dispensing technologies, including the Unit Dose Dispensing Robot (UDRs). However, no studies in Thailand have evaluated the costs and medication errors associated with UDRs. Objective: To conduct a cost-effectiveness analysis of the adoption of UDRs in comparison to traditional manual dispensing methods, focusing on costs and the reduction of medication errors. Method: Cost and medication error data were obtained from the database of a tertiary hospital in Thailand between 2017 and 2022. Medication errors were measured as the difference in error occurrence before and after UDR implementation. Cost components included labor costs, material costs, and the capital cost of UDRs. The incremental cost-effectiveness ratio (ICER) was calculated as the incremental cost per avoided medication error. One-way sensitivity analysis was performed to assess the impact of uncertainty in individual parameters on the results. Results: UDR implementation reduced wrong-drug, wrong-dose, and medication mix-up errors by 201, 62, and 6.33 events, respectively. Overall, UDRs prevented 269.34 medication errors annually at an incremental cost of 64,883.10 United States Dollars (USD), resulting in an ICER of 240.90 USD per avoided medication error. One-way sensitivity analysis indicated that the cost of medications after implementing the UDRs had the greatest influence on ICER variability, while labor costs after UDR implementation had the least impact. Conclusions: Implementing UDRs resulted in higher initial costs due to investments in infrastructure, technology, and labor; however, it significantly reduced medication errors. This evidence can be utilized to inform decision-makers in investing in automatic drug dispensers, promoting patient safety and increasing the efficiency of hospital medication dispensing systems in Thailand.
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