Diluted chemo drug scandal — why was this ever contracted out?

It looked for a while that Marchese Hospital Solutions’ explanation for the diluted chemotherapy drug bags may have had legs, suggesting there was miscommunication between hospital purchasing agent Medbuy and Marchese over the use of the product.

Marchese claimed it was their understanding that the bags of chemotherapy drugs they were preparing were to be administered as a single dose entirely to one patient, when in fact the contents of the bags were being used for multiple doses.

Appearing before a Ontario legislature committee probing how 1200 cancer patients received diluted doses of chemotherapy, Anne Miao, director of pharmacy for rival corporation Baxter, told the committee that Marchese’s explanation was far-fetched.

According to today’s Toronto Star, Miao told the committee that dosage is based on the patient’s surface area, and “a four gram dose to be used as a single-patient dose, using a standard five foot 10 inch tall patient, you’re looking at a patient of over 900 pounds.”

While hospitals have clearly had the ability to prepare these bags in-house with existing staff, the committee heard that Baxter had been previously paid between $21 and $34 in service costs per bag. Marchese dramatically underbid Baxter by offering to do the work for between $5.60 and $6.60 per bag. That alone should have raised alarm bells.

Yet when the scandal broke, hospitals like Peterborough Regional Health Centre simply resumed preparing the chemo bags themselves. According to previous testimony, that didn’t require additional staff or create workload chaos. So how did this contracting out save money or make the hospital more efficient?

The answer is it likely didn’t, and in the process, contracting out placed patients at risk.

Given Peterborough is presently in the process of eliminating more than 50 jobs to balance its budget, the public is owed an explanation as to why this contracting out ever took place in the first place. How is it that the hospital cannot afford to maintain its nurses, but it could pay as much as $34 per bag to prepare something they already had the resources and ability to do themselves for no additional cost?

There appears to be a lesson here about contracting out that the public is learning, if not the politicians.

In a recent national Vector Poll, seven in ten Ontarians said they disliked the idea of moving some medical procedures out of hospitals to clinics.

In the poll taken between April 24-30,  73 per cent said clinics will place shareholders ahead of patients. 41 per cent believed patients would be placed at greater risk in clinics. The Ontario sample error on the poll is 4.4 per cent up or down.

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