The True Cost of “Traditional” Narcotic Vials

Traditional vials look cost-effective on an invoice—until you calculate the hidden burdens of labor, drug waste, and compliance liabilities. See how switching to Simplist® ready-to-administer prefilled syringes transforms your institutional bottom line.

Analyze your facility's waste

Disclaimer: Calculator outputs are estimates intended for educational and planning purposes only. Results are based on user-entered data, published literature, publicly available wage and cost information, and modeling assumptions. Actual operational, clinical, compliance, and financial outcomes may vary. This tool does not provide legal, regulatory, reimbursement, or clinical practice guidance.

Medication Error Rate Comparison1

Traditional vial and syringe practice (including cartridge-based system) vs Simplist Ready-to-administer

Traditional Practice 10.4% Error Rate
Simplist® Ready-to-Administer 2.5% Error Rate

4x Lower Error Rate

A prospective, multisite, observational study of IV push medication preparation and administration compared the error rates between ready-to-administer products and traditional practice, including a cartridge-based syringe system and vial and syringe.

  • Simplist was the only RTA delivery system used in the study
  • Study limitations include only a select number of sites (3) and steps observed
The Narcotic Waste Calculator is best viewed on desktop

Step 1: Drug Waste Entry

Input waste data from your institution’s waste analysis.

Fentanyl Citrate Injection, USP CII (3 Strengths)

Strength

Current Cost

Average wholesale price (AWP) per unit of the current medication presentation. Prepopulated as the baseline acquisition cost in the analysis and editable to reflect facility pricing.

Simplist Cost

Cost per unit of the comparable Simplist® ready-to-administer syringe. Enter the facility-specific wholesale or acquisition price, where available.

Annual Quantity

Estimated annual units used for this drug strength, annualized from the observed waste-report period or entered manually.

Annual Waste

Estimated total medication amount wasted annually for this drug strength, reported in mg or mcg.

Waste Events

Estimated annual number of waste events for this drug strength, annualized from the observed waste-report period.

50 mcg per 1 mL

100 mcg per 2 mL

250 mcg per 5 mL

Hydromorphone HCl Injection, USP CII (5 Strengths)

Morphine Sulfate Injection, USP CII (3 Strengths)

Step 2: Operational & Labor Impact

Pre-populated with national averages and peer-reviewed literature benchmarks. Select adjust to customize.

Nursing Impact

Hourly wage used to estimate nursing labor cost. Default: $45.00/hour, based on the U.S. Bureau of Labor Statistics May 2024 median annual wage for registered nurses.2
Estimated clinician time associated with each waste event. Default: 2:32 (152.4 sec). Hertig et al. observed approximately 76.2 seconds per waste event; the calculator applies a 2× modeling factor to represent total workflow time for documentation witness.3

Annual Labor Cost:

Estimated annual nursing labor cost attributable to medication waste, calculated from waste-event volume, time per event, days observed, and RN hourly wage.

$0.00

Pharmacy Impact

Hourly wage used to estimate pharmacy technician labor cost. Default: $20.90/hour, based on the U.S. Bureau of Labor Statistics May 2024 median wage for pharmacy technicians.4
Estimated pharmacy technician time required for an initial waste-event follow-up. Default: 6:43 (403sec), based on the cited multi-site pharmacy cost study.5
Estimated share of waste events requiring pharmacy follow-up. Default: 6%; the calculator uses Bluesight’s reported controlled-substance transaction variance rate as a proxy for follow-up.6

Annual Labor Cost:

Estimated annual pharmacy technician labor cost for follow-up activity, calculated from waste-event volume, follow-up rate, time per follow-up, days observed, and technician hourly wage.

$0.00

Diversion Impact

Hourly wage used to estimate diversion analyst labor cost. Default: $30.00/hour, using the June 1, 2026 Salary.com benchmark provided for Diversion Investigators.7
Estimated diversion analyst time required for an initial investigation. Default: 11:30 (690 sec), based on the cited multi-site pharmacy cost study.5
Estimated share of pharmacy follow-ups that advance to diversion review. Default: 10.5%, based on the cited multi-site pharmacy cost study.5

Annual Labor Cost:

Estimated annual diversion analyst labor cost for investigations, calculated from applicable follow-up rates, investigation time, waste-event volume, days observed, and analyst hourly wage.

$0.00

Sustainability

Number of automated dispensing cabinets (ADCs) represented in the customer’s waste report, based on the count of unique ADC names.
Estimated number of waste receptacle exchanges per ADC each year. Default: 2 exchanges annually, based on the cited multi-site pharmacy cost study.5
Estimated maintenance cost for each waste receptacle exchange. Default: $125.00 per exchange, based on the cited multi-site pharmacy cost study.5

Annual Receptacle Cost:

Estimated annual waste receptacle cost, calculated as the number of ADCs × annual exchanges per ADC × cost per exchange.

$0.00

Step 3: Risk Exposure & Cost Avoidance

Pre-populated with national averages and peer-reviewed literature benchmarks. Select adjust to customize.

Traditional preparation using a vial and syringe showed an error rate of 10.4%, compared with 2.5% for RTA prefilled syringes. Adopting RTA protocols supports risk-reduction objectives.1
Estimated absolute difference in medication error rate between traditional IV push preparation using vial- or cartridge-based systems (10.4%) and ready-to-administer prefilled syringes (2.5%). Default: 7.9 percentage points, based on the cited prospective, multisite study.1
Modeled incremental cost difference between traditional vial-and-syringe and ready-to-administer administration. The cited study reported $182.61 lower cost per administration for the RTA arm.8

Estimated Potential Cost Avoidance:

Estimated annual cost avoidance generated by the medication-error scenario, based on the selected error-rate and cost inputs.

$0.00

Calculates exposure risk for administrative record-keeping deviations under federal enforcement baselines.
Enter the estimated number of potential DEA findings to include in the compliance-risk scenario. Default: 0.
Maximum civil penalty used in this model for certain Controlled Substances Act violations under 21 U.S.C. §842(a)(5), (10), and (17). 2025 adjusted amount: $19,246.00 per applicable violation.9

Estimated DEA Penalty Exposure:

Estimated potential civil-penalty exposure, calculated as the number of potential DEA findings × the selected civil fine per applicable violation.9

$0.00

Annual Totals

Potential Waste & Diversion Risk Reduction Opportunities

Visualizing what portion of total workflow operational load can be successfully optimized.

75% ADDRESSABLE

Annualized Addressable Waste:

0 Events

Current Total Waste:

0 Events

Full-Dose Vials Wasted:

0 Vials

Annualized Institutional Impact Summary

Acquisition Cost (PFS vs Vials):

$0.00

Labor & Operational Expenses Recovered:

$0.00

Mitigated Error Costs Avoided:

$0.00

Estimated Net Annual Impact:

Estimated net annual financial impact after combining modeled acquisition-cost differences with labor, operational, medication-error, and compliance cost savings.

$0.00

ANNUAL VALUE / NET ROI

0 hrs

Nursing Care Restored

Estimated nursing hours associated with controlled-substance waste documentation potentially recovered.3

0 hrs

Rx & Diversion Restored

Estimated pharmacy and diversion hours associated with waste follow-up potentially recovered.5,6

0

Waste Events Eliminated

Estimated annual manual waste events potentially eliminated based on facility waste data.

0

Medication Errors Avoided

Estimated annual medication errors potentially avoided based on published IV push error rates.1

Important: Calculator outputs are estimates intended for educational and planning purposes only. Results are based on user-entered data, published literature, publicly available wage and cost information, and modeling assumptions. Actual operational, clinical, compliance, and financial outcomes may vary. This tool does not provide legal, regulatory, reimbursement, or clinical practice guidance.

Marilin Wong, PharmD, MBA, DPLA

Require a presentation-ready evaluation for your P&T Committee?

Connect with Marilin Wong, PharmD, MBA, DPLA, Director, Integrated Pharmacy Solutions, to receive a financial assessment configured exclusively for your healthcare network.

1.

Drug Waste Units (Annual Vials)

=

Σ

Total Waste per SKU ÷ Drug Dose per Vial

Days Observed

×

365

2.

Drug Waste Cost (Annual)

=

Σ

Vials Wasted per SKU × Current Cost per Vial

Days Observed

×

365

3.

Annual Waste Events

=

Σ Waste Events

Days Observed

×

365

4.

Nursing Time Wasted (Annual Hours)

=

Time per Waste Event (sec) × Σ Waste Events

3,600 × Days Observed

×

365

5.

Nursing Labor Cost (Annual)

=

Annual Nursing Hours × RN Hourly Wage

6.

Pharmacy Time Wasted (Annual Hours)

=

Pharmacy Tech Time per Follow-Up (sec) × Σ Waste Events × Follow-Up Required %

3,600 × Days Observed

×

365

7.

Pharmacy Labor Cost (Annual)

=

Annual Pharmacy Hours × Pharmacy Tech Hourly Wage

8.

Diversion Analytic Time (Annual Hours)

=

Analyst Time per Investigation (sec) × Σ Waste Events × Pharmacy Follow-Up % × Diversion Follow-Up %

3,600 × Days Observed

×

365

9.

Diversion Labor Cost (Annual)

=

Annual Diversion Hours × Diversion Analyst Hourly Wage

10.

Waste Receptacle Cost

=

ADC Count × Annual Receptacle Exchanges × Cost per Replacement

11.

Potential DEA Findings Cost

=

DEA Findings × Max Civil Fine per Violation

12.

Potential Med Error Cost

=

Annual Waste Events × Med Error Rate % × Estimated Cost per Med Error

13.

Cost Avoidance Total

=

Potential DEA Findings Cost + Potential Med Error Cost

14.

Current Product Cost

=

Σ (Current Cost per Vial × Annual Quantity)

15.

Simplist Product Cost

=

Σ (Simplist Cost per Vial × Annual Quantity)

16.

Acquisition Cost Savings

=

Current Product Cost − Simplist Product Cost

17.

Labor and Drug Cost Impacts Total

=

Nursing Cost + Pharmacy Cost + Diversion Cost + (Drug Waste Cost × Addressable Fraction) + Receptacle Cost

18.

Labor, Material & Compliance Cost Saved

=

Labor and Drug Cost Impacts Total + Cost Avoidance Total

19.

Net ROI

=

Acquisition Cost Savings + Labor, Material & Compliance Cost Saved

Addressable Fraction = Annual Addressable Waste Events ÷ Total Annual Waste Events
All time inputs are in seconds; divide by 3,600 to convert to hours
Annualization pattern (applied throughout): (Observed-Period Value ÷ Days Observed) × 365
References:
  1.

Hertig, John B. PharmD, MS, CPPS*; Degnan, Daniel D. PharmD, MS, CPPS, CPHQ*; Scott, Catherine R. CPHQ*; Lenz, Janelle R. PharmD*; Li, Xiaochun PhD, MSc†; Anderson, Chelsea M. PharmD, MBA, BCPS* A Comparison of Error Rates Between Intravenous Push Methods: A Prospective, Multisite, Observational Study, Journal of Patient Safety: March 2018 – Volume 14 – Issue 1 – p 60-65 doi: 10.1097/PTS.0000000000000419.

  2.

U.S. Bureau of Labor Statistics. Registered Nurses. Occupational Outlook Handbook. Median annual wage: $93,600; $45.00/hour in May 2024.

  3.

Hertig J, Jarrell K, Arora P, et al. A Continuous Observation Workflow Time Study to Assess Intravenous Push Waste. Hospital Pharmacy. Hosp Pharm. 2021;56(5):584-591

  4.

U.S. Bureau of Labor Statistics. Pharmacy Technicians. Occupational Outlook Handbook. Median wage: $43,460/year; $20.90/hour in May 2024.

  5.

Hertig J, Louden L, Shay B, Soto A, Doan T, Gross Z. Assessing Pharmacy Costs of Intravenous Push Controlled Substance Waste in Hospital-Based Areas: A Multi-Site Study. Pharmacy. 2025;13(5):121. doi:10.3390/pharmacy13050121.

  6.

Bluesight. 2025 Diversion Trends Report: An Analysis of Drug Diversion Data From 1,100+ Hospitals.

  7.

Salary.com. Diversion Investigator Salary, Hourly Rate in the United States. User-specified benchmark dated June 1, 2026.

  8.

Arora P, Muehrcke M, Hertig J. A Cost-Effectiveness Study Comparing Ready-to-Administer and Traditional Vial-and-Syringe Method for Opioids. Pain Ther. 2022 Sep;11(3):937-950. doi: 10.1007/s40122-022-00402-z. Epub 2022 Jun 10. PMID: 35687249; PMCID: PMC9314479. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9314479/.

  9.

U.S. Department of Justice. Civil Monetary Penalties Inflation Adjustments for 2025. Final rule effective July 3, 2025; 28 CFR Part 85.

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