Interventions to reduce waste and improve billing compliance with medications in single-dose vials.

This article focuses on a process improvement project aimed at reducing inappropriate drug waste and Medicare Part B billing noncompliance for injectable drugs in single-dose vials in outpatient settings through enhancements in the electronic health record (EHR). The institution implemented a "grouper," a tool that suggests vial combinations to minimize waste, and dose rounding protocols for three high-risk drugs: bevacizumab-bvzr, carfilzomib, and ipilimumab. Comparing claims data before and after implementation showed a significant reduction in drug waste claims (from 55.1% to 20.8%) and eliminated claims with waste exceeding the smallest vial size, thereby reducing potential billing noncompliance. The interventions resulted in an estimated $828,396 reduction in drug waste costs over three months. The study highlights the potential for similar EHR-based strategies to improve drug waste management and billing compliance, especially as Medicare increases scrutiny on drug waste reimbursement.