CP-230 Health technology assessment: Choice between cytotoxic safety cabinets and isolators for cytotoxic drug reconstitution

Background This study was conducted to implement a centralised cytotoxic reconstitution unit (CCRU). In a CCRU, two types of equipments can be used: cytotoxic safety cabinets (CSCs) and isolators. Purpose The aim of this study was to compare the implementation costs of a CCRU equipped with CSC and a CCRU equipped with an isolator. Material and methods Two plans were elaborated according to the international recommendations so that the first plan satisfied the necessary requirements in the case of CSC and the second responded to those in the case of an isolator. A detailed description of both CCRUs has been detailed. For instance, the preparation room in the CCRU equipped with CSC measures 15 m 2 and its air quality responds to the ISO 5 definition, while it measures 25 m 2 in the case of an isolator and its air quality responds to ISO 7 or 8 depending on whether we use a negative or positive pressure isolator, respectively. This study compared costs of infrastructure, air treatment and equipment purchase, as well as qualifications and staff clothing in both cases. Requests for quotes for the compared items were sent to different suppliers. Results The cost of purchasing an isolator is approximately 6 times that of a CSC (140 000€ vs 24 000€). However, the requirements and costs for air treatment of the CCRU as well as clothing for staff are less in the case of a CCRU equipped with an isolator. Conclusion By excluding the cost of purchase of equipment (CSC or isolator), the overall cost for implementation of a CCRU is higher in the case of a CSC than for an isolator. Whereas by including those costs the overall cost of the CCRU becomes higher in the case of an isolator (337 000€) versus 276 000€ for a CCRU equipped with a CSC. This work should be completed by a study of the operating costs of the two types of CCRU in order to optimise the resources and find out the less expensive system. References and/or Acknowledgements Norme ISO 14644. No conflict of interest.