• Srdjan Jelacic, Karen Craddick, Bala G Nair, Mark Bounthavong, Kai Yeung, Dolly Kusulos, Jennifer A Knutson, Shabir Somani, and Andrew Bowdle.
• Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA. Electronic address: sjelacic@uw.edu.
• J Clin Anesth. 2017 Feb 1; 36: 178-183.

BackgroundAnesthesia drugs can be prepared by anesthesia providers, hospital pharmacies or outsourcing facilities. The decision whether to outsource all or some anesthesia drugs is challenging since the costs associated with different anesthesia drug preparation methods remain poorly described.MethodsThe costs associated with preparation of 8 commonly used anesthesia drugs were analyzed using a budget impact analysis for 4 different syringe preparation strategies: (1) all drugs prepared by anesthesiologist, (2) drugs prepared by anesthesiologist and hospital pharmacy, (3) drugs prepared by anesthesiologist and outsourcing facility, and (4) all drugs prepared by outsourcing facility.Main ResultsA strategy combining anesthesiologist and hospital pharmacy prepared drugs was associated with the lowest estimated annual cost in the base-case budget impact analysis with an annual cost of $225 592, which was lower than other strategies by a margin of greater than $86 000.ConclusionA combination of anesthesiologist and hospital pharmacy prepared drugs resulted in the lowest annual cost in the budget impact analysis. However, the cost of drugs prepared by an outsourcing facility maybe lower if the capital investment needed for the establishment and maintenance of the US Pharmacopeial Convention Chapter <797> compliant facility is included in the budget impact analysis.Copyright © 2016 Elsevier Inc. All rights reserved.

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