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.

Want to know more about DUPLEX®?

Speak to one of our ready-to-use team

References

1. Prakash V, Koczmara C, Savage P, Trip K, Stewart J, McCurdie T, et al. Mitigating errors caused by interruptions during medication verification and administration: interventions in a simulated ambulatory chemotherapy setting. BMJ Quality & Safety. 2014 Nov 1;23(11):884–92.

2. Raja, Badil, Ali S, Sherali S. Association of medication administration errors with interruption among nurses in public sector tertiary care hospitals. Pakistan Journal of Medical Sciences. 2019 Aug 7;35(5).

3. Elliott RA, Camacho E, Jankovic D, Sculpher MJ, Faria R. Economic Analysis of the Prevalence and Clinical and Economic Burden of Medication Error in England. BMJ Quality & Safety. 2021;30(2):96–105.

4. Sutherland A, Canobbio M, Clarke J, Randall M, Skelland T, Weston E. Incidence and prevalence of intravenous medication errors in the UK: a systematic review. European Journal of Hospital Pharmacy. 2018 Oct 23;27(1):ejhpharm-2018-001624.

5. The Health Foundation. Nursing locally, thinking globally: UK-registered nurses and their intentions to leave - The Health Foundation. www.health.org.uk. 2024.

6. DHSC. Transforming NHS Pharmacy Aseptic Services in England A national report for the Department of Health and Social Care by Lord Carter of Coles Contents. 2020.

7. Sessink PJM, Nyulasi T, Haraldsson ELM, Rebic B. Reduction of Contamination with Antibiotics on Surfaces and in Environmental Air in Three European Hospitals Following Implementation of a Closed-System Drug Transfer Device. Annals of Work Exposures and Health. 2019 Mar 10;63(4):459–67.

8. Sessink P, Tans B, Devolder D, Rik Schrijvers, Spriet I. Evaluation of environmental antibiotic contamination by surface wipe sampling in a large care centre. Journal of Antimicrobial Chemotherapy. 2024 May 9;79(7):1637–44.

9. RCN. Publications | Royal College of Nursing [Internet]. The Royal College of Nursing. 2021.

10. NHS Resolution. Preventing needlestick injuries [Internet]. NHS Resolution. 2023.

11. NHS England (n.d.) Medicines value and access. Available at: https://www.england.nhs.uk/medicines-2/medicines-value-and-access/

12. Barbariol F, Deana C, Lucchese F, Cataldi G, Bassi F, Bove T, et al. Evaluation of drug wastage in the operating rooms and intensive care units of a regional health service. Anesthesia & Analgesia. 2021 Mar 5;132(5).

13. B. Braun US. Ready-to-Use DUPLEX Container [Internet]. Bbraunusa.com. B. Braun Melsungen AG; 2025.

14. B. Braun. DUPLEX®: An Innovative IV Antibiotic Preparation Device to Release Time to Care and Aseptic Capacity. Poster Abstract Presented at QATS 2024. 2024.

15. NHS England. (2025). Business case template for developing or expanding outpatient parenteral antimicrobial therapy (OPAT) services. Retrieved from https://www.england.nhs.uk/long-read/business-case-template-for-developing-or-expanding-outpatient-parenteral-antimicrobial-therapy-opat-services/

16. NHS England. (2019). The NHS Long Term Plan. Retrieved from https://www.england.nhs.uk/long-term-plan/

17. Larmené-Beld KHM, Spronk JT -, Luttjeboer J, Taxis K, Postma MJ. A Cost Minimization Analysis of Ready-to-Administer Prefilled Sterilized Syringes in a Dutch Hospital. Clinical Therapeutics. 2019 Jun;41(6):1139–50.

18. Lyons I, Furniss D, Blandford A, Chumbley G, Iacovides I, Wei L, et al. Errors and discrepancies in the administration of intravenous infusions: a mixed methods multihospital observational study. BMJ Quality & Safety. 2018 Apr 7;27(11):892-901.18