{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T12:06:14Z","timestamp":1792843574969,"version":"4.5.0"},"reference-count":32,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Injectable medicines represent a significant proportion of the annual medicines expenditure of the NHS in England, totalling \u00a37 billion ($9.4 billion, \u20ac8.0 billion) in 2023. This represents approximately 70% of hospital medicines spending and includes essential treatments delivered at the point of care, such as chemotherapy; clinical trial drugs; and intravenous nutrition. Licensed ready\u2010to\u2010administer injectable products are manufactured and labelled for immediate use, eliminating the need for preparation or dilution by clinical staff, thereby enhancing efficiency and reducing risks. Despite the recognised benefits of ready\u2010to\u2010administer products for safety and productivity, most NHS hospitals favour traditional vials due to lower initial acquisition costs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched for studies evaluating the clinical or economic impact of ready\u2010to\u2010administer intravenous medications in hospital settings. Grey literature from NHS and UK government sources was also reviewed. Inclusion criteria comprised English language studies assessing cost; waste; preparation time; or medication errors associated with ready\u2010to\u2010administer use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sixteen studies were included in the review. Ready\u2010to\u2010administer products generally reduced preparation errors, drug wastage and preparation time, but variability in outcome measures and their definitions precluded meta\u2010analysis. Evidence suggesting fewer adverse drug events and workflow interruptions derived mainly from observational studies and surrogate outcomes. Economic evaluations indicated potential savings from avoided errors, reduced waste and staff time, though estimates were context\u2010specific and assumption\u2010dependent. Overall, the risk of bias varied across studies and the predominance of small, single\u2010centre, non\u2010randomised designs limits generalisability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Licensed ready\u2010to\u2010administer products are associated with fewer preparation errors, shorter preparation times and reduced drug waste, with plausible economic benefits. The certainty of this conclusion is limited by heterogeneous, largely non\u2010randomised designs and context\u2010specific costs. Evidence specific to the UK is sparse. Multicentre studies with standardised outcomes and robust micro\u2010costing are needed to define clinical impact, budget impact and implementation requirements.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.70122","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T06:05:10Z","timestamp":1768457110000},"page":"867-874","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Economic evidence for licensed ready\u2010to\u2010administer intravenous products compared with standard vials and ampoules: a systematic review"],"prefix":"10.1111","volume":"81","author":[{"given":"Suzanne","family":"Al\u2010Rawi","sequence":"first","affiliation":[{"name":"Infusions and Special Medicine Programme NHS England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Greening","sequence":"additional","affiliation":[{"name":"Infusions and Special Medicine Programme NHS England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Ladds","sequence":"additional","affiliation":[{"name":"Infusions and Special Medicine Programme NHS England  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"Rx\u2010info.NHS secondary care prescribing and spend data.https:\/\/www.rx\u2010info.co.uk."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs\u20102019\u2010010206"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.g1202"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/ejhpharm\u20102018\u2010001624"},{"key":"e_1_2_6_6_1","unstructured":"CarterP.Transforming NHS Pharmacy Aseptic Services in\u00a0England.2020.https:\/\/assets.publishing.service.gov.uk\/media\/5f9afdbdd3bf7f1e405d9a23\/aseptic\u2010pharmacy.pdf."},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.16166"},{"key":"e_1_2_6_8_1","unstructured":"Royal Pharmaceutical Society.Professional Guidance on the Safe and Secure Handling of Medicines.2018.https:\/\/www.rpharms.com\/recognition\/setting\u2010professional\u2010standards\/safe\u2010and\u2010secure\u2010handling\u2010of\u2010medicines\/professional\u2010guidance\u2010on\u2010the\u2010safe\u2010and\u2010secure\u2010handling\u2010of\u2010medicines."},{"key":"e_1_2_6_9_1","unstructured":"Specialised Pharmacy Service.Multiple use of injectable medicines in clinical areas.2020.https:\/\/www.sps.nhs.uk\/wp\u2010content\/uploads\/2019\/12\/Multiple\u2010Use\u2010of\u2010Injectable\u2010Medicines\u2010in\u2010Clinical\u2010Areas\u2010V2\u2010February\u20102020.pdf(Accessed: 19 November 2021)."},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000001035"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aes222"},{"key":"e_1_2_6_12_1","article-title":"Prefilled syringes for intravitreal injection reduce preparation time","volume":"63","author":"Subhi Y","year":"2016","journal-title":"Dan Med J"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325\u2010021\u201002003\u20102"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13049\u2010018\u20100549\u20103"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/ejhpharm\u20102022\u2010003620"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102021\u2010055551"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2012.05.007"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.accpm.2016.08.003"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/NAN.0000000000000457"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2017.07.158"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0018578720926166"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinthera.2019.04.030"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1213\/ane.0000000000005457"},{"key":"e_1_2_6_24_1","unstructured":"The Royal College of Nursing.Royal College of Nursing responds to the latest NHS England Vacancy Statistics.2023.https:\/\/www.rcn.org.uk\/news\u2010and\u2010events\/Press\u2010Releases\/rcn\u2010responds\u2010to\u2010the\u2010latest\u2010nhs\u2010england\u2010vacancy\u2010statistics\u2010aug2023."},{"key":"e_1_2_6_25_1","doi-asserted-by":"crossref","unstructured":"Department of Health and Social Care.Fit for the future: 10 Year Health Plan for England. 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