Economic evaluation of a robotic chemotherapy compounding system and its service expansion to network hospital in Thailand.

Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Robotics*/economics ; Drug Compounding*/economics ; Drug Compounding*/methods ; Antineoplastic Agents*/administration & dosage ; Antineoplastic Agents*/economics; Thailand ; Humans ; Cost-Benefit Analysis

Competing Interests: Declarations. Ethics approval and consent to participate: This study was reviewed and approved by the Ethics Committee of Udon Thani Cancer Hospital (IRB Protocol No. UDCH_COA 014/2023, approval date: August 4, 2023). Written informed consent to participate was obtained from all participants prior to data collection. The study was conducted in full compliance with the ethical principles of the Declaration of Helsinki (2013 revision), as set forth by the World Medical Association. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.
Background: Robotic systems for chemotherapy preparation offer improved accuracy and staff safety but require substantial capital investment. This study assessed the economic performance of a domestically developed robotic chemotherapy compounding system at Udon Thani Cancer Hospital and its service expansion to a network hospital in Thailand.
Methods: A descriptive study with economic evaluation was conducted, including cost-benefit analysis, unit cost analysis, and break-even analysis from both provider and health system perspectives. Data from fiscal year 2023 were used. Direct and indirect costs were assessed, and clinical outcomes were documented. A scenario-based sensitivity analysis was performed to examine cost variations under different capacity utilisation levels.
Results: Robotic preparation had a higher per-dose cost (THB 538 for 4,173 doses) than manual preparation (THB 250 for 20,310 doses), but was associated with total estimated economic benefits of THB 1.88 million, including labour and training savings and improved pharmaceutical care. The break-even point was estimated at 41,802 doses for robotic compounding and 5,122 doses for service expansion. The incremental benefit-cost ratio (IBCR) was 1.566 and increased to 3.018 when including delivery to the network hospital.
Conclusions: The robotic system demonstrated potential economic and operational advantages, particularly when scaled to serve additional facilities. These findings offer preliminary evidence to inform future policy considerations under Thailand's Cancer Service Plan. Further evaluation is needed to assess long-term sustainability and broader system-level outcomes.
(© 2025. The Author(s).)

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Keywords: Chemotherapy Preparation; Cost‒benefit analysis; Economic evaluation; Health system perspective; Robotic compounding; Thailand

0 (Antineoplastic Agents)

Date Created: 20250730 Date Completed: 20250731 Latest Revision: 20250803

20250803

PMC12308934

10.1186/s12913-025-13186-7

40739256