Economic Evaluation of a Robotic Chemotherapy Compounding System and its Service Expansion to Network Hospitals in Thailand

Background: Robotic systems for chemotherapy preparation offer increased accuracy and staff safety but require high capital investment. This study evaluated the cost-effectiveness of a locally developed robotic chemotherapy compounding system at Udon Thani Cancer Hospital and its expansion to network hospitals in Thailand. Methods: A descriptive study with economic evaluation was conducted, including cost‒benefitanalysis, unit cost analysis, and break‒even analysis from both provider and health system perspectives. Data were collected during the fiscal year 2023. Direct and indirect costs were analyzed, and clinical outcomes were tracked. A one-way sensitivity analysis was used to assess the robustness of the results. Results: Robotic preparation had a higher per-dose cost (THB 538) than manual preparation did (THB 250) but provided economic benefits, including labor and training savings, improved pharmaceutical care, and error reduction. The incremental benefit‒cost ratio (IBCR) was 1.566. When expanded to network hospitals, robotic compounding and delivery had an IBCR of 3.018, indicating strong cost-effectiveness. Conclusions: Robotic chemotherapy compounding systems show potential economic and operational benefits, particularly in regional settings. These findings provide initial evidence to inform policy considerations under Thailand’s Cancer Service Plan, though further research is needed to confirm long-term cost-effectiveness.