Supplementary file 4: Unit cost per dose bag
The unit cost per dose bag was the total costs of the automated dispensing machine divided by the number of produced dose bags in full-scale implementation (2,045,000 unit dose bags per year). The unit cost per dose bag included the purchase costs of the dispensing machine, facilities and the estimated annual operating cost of the dispensing machine.
The purchase costs of the automated dispensing machine, eMAR integration, and development of the PDA application wereused to calculate an annual equivalent cost using an interest rate of 5% and an annuity of 17 years.
The facilities costs were calculated using the national average cost per square meter for new hospital construction in Denmark [51]. The automated dispensing machine required 90 m2 of floor space. This space was doubled to account for dressing rooms, toilets, and other necessary amenities and multiplied by the average cost per m2 to determine the total cost of the physical facilities. The total facility costs were then transformed to an annual equivalent cost using an interest rate of 5% and an annuity of 17 years.
Handling time was estimated separately for each relevant department and staff group in the hospital pharmacy based on the present resource use. The estimated handling time was extrapolated to full-scale production and 15 daily opening hours accounting for economies of scale.
The annual running costs were estimated by multiplying the annual hours of operation by a running cost of 12 € per opening hour and included continuous service agreement and waste management expenses.
Table: Unit cost per dose bag estimation(2016-€)
N dose bags / Costs (€) / Costs per dose bag (€)Staff costs (full scale production)
Technical staff / 199,579
Service staff / 154,854
Managerial staff / 84,838
Pharmaceutical staff / 307,633
Dispensing machine, technical and IT developments / 424,387
Facilities (180m2) / 4,700
Running costs (electricity, ventilation, heat ect.) / 64,058
Service agreements / 54,486
Estimated waste / 4,436
Annual costs / 1,298,970
Annual capacity of the dispensing machine (full scale production) / 2,545,000
Costs per dose bag / 0.51 €
Purchase price per dose bag / 0.06 €
Unit costs per dose bag (full scale production) / 0.58 €
Facilities: estimated costs per m2, when building new hospitals 2860-2990 € per. m2. (Excl. IT). Space need for the dispensing machine (180 m2 - net 90m2) this amounts to between 514,800 -538,200 € in construction.
The annuity was estimated to 17 years (acquisition 2003 - life expectancy 2020), interest rate 5% p.a. This results in annual construction costs of45,662 - 47,738 €. The average; 46,700 was used in the cost analysis as costs of facilities.
The same model was used to amortize the costs of the dispensing machine, technical and IT developments.