Pharmacist-led redesign of chemotherapy delivery and supportive care: effects on infusion capacity, aseptic workload, costs and resource stewardship in oncology practice

Introduction Medication-related processes in oncology are complex and resource intensive, creating opportunities for treatment delays, preparation burden, medication errors, and inefficient resource utilization. Pharmacist-led interventions have been associated with improvements in medication safety, efficiency, and costs, yet evidence evaluating their system-wide impact remains limited. This study evaluated an integrated pharmacist-led, multidisciplinary redesign of medication-use processes encompassing supportive medications, infusion administration, and drug preparation in a tertiary oncology center. Materials and methods We performed a retrospective analysis of routinely collected administration data from January to June 2023. Baseline practice (3,750 administrations) was compared with a modelled full-implementation scenario. Scheduled administration time (SAT) was used as an operational measure of infusion-unit resource use. Aseptic workload, direct acquisition costs, and assessed single-use consumable waste were estimated using prespecified model rules, measured unit weights, and 2023 institutional acquisition prices. A pragmatic February 2026 substudy compared current SAT with real administration time, reconstructed baseline equivalent SAT, and modelled full-implementation SAT. Results Baseline cumulative SAT was 8,945 h. IV supportive medications accounted for 1,801 SAT h and 680 h of aseptic preparation time. In the modelled full-implementation scenario, total SAT decreased by 43% (−3,851 h), aseptic workload by 666.8 h, direct acquisition costs by €20,276, and assessed single-use consumable waste by 331.6 kg. In the February 2026 substudy, current SAT closely approximated real administration time and indicated that a substantial proportion of the modelled SAT reduction had already been achieved in routine practice. Discussion To our knowledge, this is the first study to simultaneously quantify infusion service capacity, aseptic workload, direct costs, and consumable waste within a pharmacist-led, multidisciplinary oncology redesign framework. By streamlining medication-use processes across multiple stages of care, such interventions may contribute to safer medication delivery, improved resource stewardship, and greater infusion service capacity. This model represents a scalable and policy-relevant approach to supporting high-quality cancer care while promoting long-term healthcare sustainability.