Small but Mighty Vial2Bag Advanced® 13mm Admixture Device Delivers as IV Drug Infusion Powerhouse

Daily pharmacies in 6,120 U.S. hospitals dispense millions of IV medications to patients but the process to prepare and deliver a drug infusion can vary drastically between hospitals. The distribution practice or delivery system selected for an IV drug therapy can impact critical factors including time to treatment, pharmacy workflow, nursing efficiency, and cost. Determining the best practice for IV drug distribution falls on the shoulders of pharmacy leaders who are navigating supply disruptions1, rising costs2, safety challenges3, and regulatory changes4 that influence IV drug therapy management decisions. Assessing how hundreds of IV medications are dispensed can be complicated and arduous, but pharmacy directors, who optimize drug product utilization with point-of-care admixture practices, can reduce costs and improve pharmacy workflow.5,*** The new, highly anticipated Vial2Bag Advanced® 13mm admixture device is indicated to serve as a connection between a 50, 100, or 250ml IV bag* and drug vials with a 13mm closure.** These drugs are available in small vials and volumes, but the ability to move them to point-of-care can have an enormous impact on the cost and efficiency of IV drug delivery.

A 2019 Journal of Pharmacy Practice study compared point-of-care admixture practices to local pharmacy compounding and purchase of ready-to-use (RTU) infusions for 12 medications and reported an extrapolated yearly cost avoidance (EYCA) of $2,295,261 and 41,082 yearly sterile product room units avoided.5,*** While less than 20% of the drugs reviewed in the study were in 13mm vials, they accounted for more than 50% of the total cost avoidance or over $1.2 Million of the total savings potential. A 13mm admixture device designed for point-of-care has the potential to drastically reduce costs and streamline efficiencies for these critical medications.

The 20mm Vial2Bag Advanced® admixture device is used by thousands of hospitals in the U.S. for vials with 20mm closure. Like the 20mm Vial2Bag Advanced admixture device, the 13mm device is compatible with all manufacturers’ 50, 100, and 250mL IV fluid bags, * plus liquid and powder drugs. ** The Vial2Bag Advanced® admixture device’s compatibility with any brand IV bag* can help establish flexibility and IV infusion practice stability even with pervasive IV bag supply shortages. Together, the powerful Vial2Bag Advanced® products provide a point-of-care admixture solution for as many drugs as possible, enabling practice stability, efficiency, and consistency. **

An April 2023 Pharmacy Practice News Special Report, Vial2Bag Advanced® 20mm Admixture Device: Cost Reduction and Operational Efficiency, reviewed the potential impact of the Vial2Bag® Advanced admixture device on drug delivery times, Automated Dispensing Cabinet (ADC) optimization, pharmacy workflow, and IV infusion efficiencies. Admixing by nursing at the point-of-care can potentially reduce the time to first-dose for critical medications and may further optimize automated dispensing systems (ADS) which has been shown to reduce medication errors associated with preparation and administration timing.7 Pharmacies are maximizing IV drug distribution efficiency by optimizing ADS utilization, supporting safe AND timely medication delivery to patients.

In September 2023 a second Pharmacy Practice News Special Report, Vial2Bag Advanced® 20mm Admixture Device: Prioritizing Waste Reduction in IV Medication Distribution, was published. The article concludes, “Pharmacy waste reduction, in all its forms, can help improve pharmacy workflow, patient safety, and reduce costs.” Preparing medications as close to the time of administration as possible using point-of-care admixture practices, reduces wasteful and restrictive Beyond-Use-Dating (BUD) required with advanced pharmacy compounding. * Point-of-care admixture practices can give back years of drug shelf-life by enabling the use of the drug manufacturer’s expiration date on the vial instead of shortening it to days with advanced compounding.

Vial2Bag Advanced® 13mm and 20mm Admixture devices enable a variety of drugs to be shifted to point-of-care**, maximizing cost savings and workflow efficiencies for the hospital. To ensure a successful point-of-care admixture program, the team at Progressive Medical, Inc. (“PMI”) partners with hospital leadership to manage the transition. Each hospital is offered a custom point-of-care analysis to enable the pharmacist to assess the cost and operational impact of transitioning to point-of-care admixture practices for the drugs currently dispensed. Additionally, PMI collaborates with hospitals to implement these point-of-care admixture devices by offering our comprehensive onboarding program designed to assist in achieving USP <797> immediate-use competency requirements.

Together, the Vial2Bag Advanced® 13mm and 20mm admixture devices are providing a new opportunity for hospitals to standardize admixture practices and develop a resilient IV distribution strategy that is flexible in the face of shortages. Directors of pharmacy are rethinking what nurses can accomplish at point-of-care by moving simple one-to-one drug preparation out of the pharmacy cleanroom while reducing reliance on expensive premade or outsourced alternatives.

Vial2Bag The April 2023 State of Pharmacy Compounding by Pharmacy Purchasing & Products reported that 70% of hospitals are utilizing point-of-care devices but, with the recent revision to USP <797>offering clarification to the provisions for immediate-use compounding,4,8 some expect increased adoption of this effective IV distribution strategy. With the portfolio of Vial2Bag Advanced® admixture devices, pharmacy leadership can finally design and build an effective, sustainable IV drug distribution strategy. Standardizing to a practice that can safely and reliably provide medication to the patient, with minimal delay, in the most efficient and cost-effective means, is the superior option for the hospital, the clinicians, and the patient.

Vial2Bag Advanced® 13mm and 20mm admixture devices are intended for U.S. healthcare professional use only.
* ISO 8536-4 standard IV spike.
** The Vial2Bag Advanced® 13mm admixture device is indicated to serve as a connection between a 50, 100 or 250mL IV bag, vial with 13mm closure, and an external IV administration set. The integrated vial adapter makes it possible to reconstitute and/or admix drugs prior to administration to the patient. Indicated for adolescent and adult patients only.

The Vial2Bag Advanced® 13mm and 20mm admixture devices are 510(k) cleared by the United States Food and Drug Administration (FDA). The use of the Vial2Bag Advanced® 13mm and 20mm admixture devices should not be interpreted as modifying, extending, or superseding a drug manufacturer’s labeling recommendations for storage and expiration dating, unless otherwise limited by USP <797> compounding standards. Refer to drug manufacturer’s labeling and use instructions for recommendations, USP <797>, and applicable institution policy for shelf life and sterility information of reconstituted product and admixture device compatibility. Compatibility of the Vial2Bag Advanced® 13mm and 20mm admixture devices with all drug products has not been confirmed. Do not use the Vial2Bag Advanced® 13mm and 20mm admixture devices with lipids. Failure to follow the instructions provided may result in inadequate medication reconstitution, dilution, and/or transfer, possibly leading to overdose or underdose and/or delay in therapy. Products shown are for INFORMATION purposes only and may not be approved for marketing in specific regions. Please contact your West Pharmaceutical Services, Inc. (West) representative for product availability. Important product and safety information and warnings at: and
***Evaluation of Cost, Workflow, and Safety of Implementing a Vial Transfer Device for Ready-to-Mix Drugs at an Academic Medical Center, Journal of Pharmacy Practice, 2020. Study results yielded from a single-center retrospective analysis performed from June 2017 to July 2018 by an academic medical center using West’s older Vial2Bag DC device, which is no longer commercially available and has been replaced with devices in the Vial2Bag Advanced® admixture device portfolio
West and the diamond logo are registered trademarks of West Pharmaceutical Services, Inc. in the United States and other jurisdictions. Vial2Bag Advanced and logo, Blue Vial Adapter, and Orange Vial Adapter are registered trademarks of West Pharma. Services IL, Ltd., a subsidiary of West Pharmaceutical Services, Inc.

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3. Cohen MR, Smetzer JL, Vaida AJ. ASHP guidelines on preventing medication errors in hospitals: advancing medication safety to the next level. Am J Health Syst Pharm. 2018;75(19):1444-1445.
4. Pharmacy Purchasing & Products. USP<797> Immediate-Use CSPs: Small Changes, Big Impact. Accessed February 6, 2024.
5. Tran LK, Anger KE, Dell’Orfano H, Rocchio MA, Szumita PM. Evaluation of Cost, Workflow, and Safety of Implementing a Vial Transfer Device for Ready-to-Mix Drugs at an Academic Medical Center. Journal of Pharmacy Practice. 2021;34(6):908-912.
6. Vial2Bag Advanced® Admixture Device. Instructions for use. West Pharmaceutical Services, Inc. 2023.
7. Chapuis C, Routit M, Bal G, et al. Automated drug dispensing system reduces medication errors in an intensive care setting. Crit Care Med. 2010;28(12):2275-2281.
8. United States Pharmacopeia (USP), General Chapter <797> Pharmaceutical Compounding- Sterile Preparations. [2008] USP-NF. Rockville, MD: United States Pharmacopeia. Accessed February 7, 2024.