How Ready-to-Use Medicines Benefit Patients, Staff, and the NHS

Preparing an IV antibiotic involves a sequence of meticulous steps. The clinician must draw up the correct solution, measure exact doses, and label each syringe with precision. Each stage demands focused attention and technical accuracy, as even minor deviations can compromise the final product^1,2. The process is not just routine - it’s a detailed procedure that must be executed flawlessly. The statistics are sobering: 237 million medication errors annually³, with ~10.1% of IV administrations involving an error⁴. 

This scenario unfolds thousands of times daily across the NHS and it exists within a wider context of systemic strain. A range of interconnected challenges continue to impact medication management across the NHS. With over 42,000 nursing vacancies⁵, workforce capacity is stretched, and the time-intensive nature of medication preparation equates to the workload of approximately 4,000 full-time nursing roles⁶. 

The physical environment adds further complexity - studies have identified traces of eight different antibiotics on preparation surfaces^7,8, raising concerns about contamination and staff exposure. Meanwhile, needlestick injuries have surged by 50% since 2008⁹, with NHS Resolution recording 1,947 successful claims totalling £10.8 million over the past decade¹⁰. 

Medicines now represent a £19 billion annual spend¹¹, second only to workforce costs, yet research shows that up to 71% of some prepared medications are discarded unused¹², highlighting significant inefficiencies. 

What if we could break this cycle? 

B. Braun's DUPLEX^® system offers a compelling alternative. This innovative, ready-to-use dual-chamber IV bag keeps drug and diluent separate until activation¹³, eliminating complex preparation steps¹⁴. A study demonstrated that DUPLEX^® reduced preparation steps from 18 to 4 and preparation time by 81% compared to traditional methods (4:02 to 0:45 minutes)¹⁴. The system generated 81% less waste per dose (14.83g vs. 78.04g) and required 90% fewer products¹⁴. All 102 nurses in the study rated DUPLEX^® as "much better" or "better" than traditional methods for preparation safety and ease of use¹⁴. 

The benefits extend beyond individual patients. By dramatically reducing preparation time¹⁴, DUPLEX^® could potentially release thousands of nursing hours back to direct patient care. Environmental contamination risks drop with fewer manipulation steps¹⁴. Public confidence in the system was high, with 92.3% of study participants (48/52) expressing confidence in home use¹⁴, creating opportunities to improve access to outpatient therapy, potentially freeing up hospital beds. 

Ready-to-use (RTU) antimicrobial medicines play a pivotal role in enhancing Outpatient Parenteral Antimicrobial Therapy (OPAT) services, offering an efficient and scalable alternative to inpatient care. As outlined in NHS England’s business case for expanding OPAT, RTU infusible antimicrobials enable timely discharge and admission avoidance, freeing up hospital capacity for acute, elective, and cancer care¹⁵. This aligns directly with the NHS 10-Year Plan’s commitment to delivering care closer to home, supporting workforce innovation¹⁶. 

Lord Carter’s 2020 review of NHS Pharmacy Aseptic Services emphasised the need for national initiatives to expand access to RTU medicines, particularly for home-based OPAT delivery⁶.  With over 56,000 patients annually estimated to benefit from OPAT, and up to one million inpatient days potentially avoided, RTU formulations are essential to achieving cost-effective, patient-centred care while supporting the NHS’s long-term sustainability goals¹⁵. 

While acquisition costs exceed traditional methods, economic analysis demonstrates substantial downstream savings. Research shows shifting 50% of IV medication use to ready-to-use products could yield potential annual savings of €4.9 million in a single hospital¹⁷. 

By transforming medication delivery, ready-to-use medicines offer an opportunity to simultaneously improve patient safety, enhance staff wellbeing, and address system sustainability. The solution is available today – the next step is turning evidence into action.