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Research Letter |

Estimated Cost of Injectable Medication Waste Attributable to Syringe Dead Space

Christine U. Oramasionwu, PharmD, PhD1; Ashley L. Cole, MPH1; Matthew S. Dixon, PharmD1; Susan J. Blalock, PhD1; Gary A. Zarkin, PhD2; Laura J. Dunlap, PhD2; William A. Zule, DrPH2
[+] Author Affiliations
1Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill
2RTI International, Research Triangle Park, North Carolina
JAMA Intern Med. 2016;176(7):1025-1027. doi:10.1001/jamainternmed.2016.2301.
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This study estimates differences in the cost of injectable medication waste attributable to high vs low dead-space syringes.

Excess waste is a well-known known driver of inefficiency in the US health care system. Medication waste contributes to this inefficiency and has recently been described among cancer medications,1 but it may also be attributable to the syringes used to deliver injectable medications. Syringe dead space is the volume of residual fluid that remains within the syringe after the plunger is fully depressed during medication injection.2,3 High dead-space syringes (HDSS), compared with low dead-space syringes (LDSS), are associated with increased risk for medication waste.25 If costly injectable medications are administered using HDSS, syringe dead space may contribute to excess medication waste in the US health care system. We estimated differences in the cost of injectable medication waste attributable to HDSS and LDSS.

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Figure 1.
Cost of 1-Month Supply of Medication, by Syringe Classification

The median cost of a 1-month supply of medication for those administered using high dead-space syringes (HDSS) compared with those administered using low dead-space syringes (LDSS). The box plot indicates median and interquartile. The error bars indicate range.

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Figure 2.
Median Cost of Medication Waste Attributable to Dead Space, by Duration and Syringe Classification

The median cost of medication waste attributable to dead space for medications administered using high dead-space syringes (HDSS) compared with medications administered using low dead-space syringes (LDSS). The error bars indicate interquartile ranges.

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