The University of North Carolina (UNC), North Carolina Cancer Hospital was the first program in the nation to adopt a closed-system transfer device that has saved $39 million in drug expense annually by reducing waste. This 2018 ACCC Innovator Award recipient will describe the process behind drug vial optimization at the ACCC 35th National Oncology Conference in October. In this guest blog post, Lindsey Amerine, PharmD, BCPS, provides a preview.
Total medication costs in hospitals and clinics have increased by 49% ($65.7 billion to $98.2 billion) from 2011 to 2016.1,2 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.3
In October 2011, UNC’s Department of Pharmacy implemented a drug vial optimization program, the first of its kind in the United States. 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. Theprocess has led to significant financial, safety, and clinical outcomes.
Through drug vial optimization, our organization has decreased drug waste by 94% from 2011 to 2016, saving UNC millions of dollars in drug expenses annually. The drug waste reduction program has also decreased the number of closed-system transfer devices (PhaSeal vial protectors) needed due to fewer vials being opened, thus requiring fewer vial protectors.
Patient Safety Implications
During implementation of the drug vial optimization program, patient safety was a top priority, and it continues to be our 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 (e.g., handwashing), so the goal for our program was not to experience a CLABSI rate increase after implementation; instead, our CLABSI rate decreased following drug vial optimization implementation.
We will be presenting details on our drug vial optimization program at the ACCC 35th National Oncology Conference, October 17-19, 2018, in Phoenix, Arizona.
Guest blogger Lindsey Amerine, PharmD, MS, BCPS, is the associate director of pharmacy for Infusion Services, Investigational Drug Services, Medication Assistance Program, Revenue Integrity, and WakeBrook Hospital at the University of North Carolina Medical Center. An article on the drug vial optimization program will be published in Oncology Issues in coming months.
References
At the 2026 ASCO Annual Meeting, the Louisiana Oncology Society received the ASCO Jeffrey C Ward Affiliate Advocacy Award for advancing critical advocacy priorities that have translated into meaningful legislative victories. The Iowa Oncology Society and Washington State Medical Oncology Society were also recognized for their advocacy efforts in 2025 at the meeting, receiving second place awards.
