HHE Oncology 2019 | Page 13

ONCOLOGY New challenges for aseptic drug preparation Notwithstanding the need for contingency planning, the use of automation seems to be the natural next step forward for a safer and more efficient compounding of hazardous medicines Paul Sessink PhD Exposure Control Sweden AB Cancer Research UK states that between 2014 and 2016, 363,484 new cases of cancer were reported and, with year-on-year increases, these drugs will only become more commonly used. Furthermore, in 2018, a National Health Service (NHS) commissioned report recorded an increase in demand for aseptically prepared products of around 5% per year. 1 Demand is likely to grow further with increased usage of advanced therapy medicinal products (ATMPs), growth in clinical trials, and potentially the necessity to address the sizeable unmet need for central intravenous additive services and monoclonal antibodies. To compound the issue, demand for aseptic medicines is predicted to continue to increase in line with global drug expenditure, and in particular, injectable medicine, for which sales 13 HHE 2019 | hospitalhealthcare.com are growing at 7.3% compound annual growth rate (CAGR). 2 Aseptic compounding: The current state of affairs Currently, the NHS relies on commercial suppliers for at least a third of aseptic compounding needs with 180 known NHS aseptic facilities in England (excluding radiopharmacies) and 17 sites that completely outsource production. The 2018 report suggests that the reason for this reliance on commercial suppliers is that ‘Trusts who have chosen to outsource did so for cost efficiency, investment, or capacity reasons.’ 3 Apart from demand, the NHS is contending with several other “compounding” issues. The first is that aseptic preparation is labour intensive and many facilities do not have the numbers of staff required to keep up with demand.