Today we proudly announce the launch of our Vial Combinator, a tool to help pharmacists streamline the prescription filling process. As treatment for hemophilia patients advances rapidly, so too must the tools of the clinicians that serve them.

The Problem: When pharmacists fill prescriptions for their patients with hemophilia and other bleeding disorders, they must manually calculate the optimal combination of vials for each patient’s prescription. This tedious calculation is dependent on the vial sizes available at that time, the patient’s preferences, and the error margins allowed by the physician. Each patient’s prescription can take 15 minutes or more and still leaves room for human error. 

Let’s work through an example from the perspective of a pharmacist. Our sample patient, Greg, takes 7000 IU of Hemophilia Drug A twice a week. We first consider the error margins allowed by the physician. At ± 5%, we determine that the patient’s dose can be anywhere from 6650 to 7350 IU. We then check the email from the pharmaceutical company detailing the available vial sizes for that week:

531, 1050, 1030, 1020, 2000, 1980, 2020, 3060, 3110, 3090

We skim the list, using trial and error to satisfy the conditions set above. Patients want the least number of vials, so we see if the prescription can be filled with 2 vials first. If no, we try numerous combinations of 3 vials, then 4 vials, and so on until we find a solution that is closest to the prescribed amount. Many patients require 3-4 vials per dose, but some can use 7 vials or more. This is further complicated by the fact that the same vial size can be used more than once, and pharmacies are often working under strict deadlines for next-day delivery.

The Solution: Enter the MicroHealth Vial Combinator, a simple solution that allows you to quickly 1) enter the available inventory 2) set your conditions, and 3) view optimal solutions. Free, user-friendly, and widely accessible, the Vial Combinator will simplify the workflow for hemophilia pharmacists everywhere by reducing the calculation time from 15+ minutes per patient to ~30 seconds. Additionally, you are certain that you have the best answer. Take a look at the interface below:

The Vial Combinator displays multiple solutions to help pharmacists balance priorities. Giving a patient too many vials makes the infusing process more difficult which could negatively affect adherence. However, hemophilia medication is quite expensive, and using more medication than necessary (even if in fewer vials) could result in additional costs to the patient and their insurance company. Displaying the vial quantity and percent deviation makes it easy to weigh the pros and cons of each option.

The standard version of the Vial Combinator is available for free on the MicroHealth.org homepage. Additional features are available to registered MicroHealth professional users, including auto-saving vial sizes and loading patients’ doses and vial preferences.

The Vial Combinator is the latest addition to our suite of digital tools for the hemophilia community. We believe in filling the gaps in care from every angle, as healthcare is an ecosystem of interconnected entities. It is essential to support all components of the system, from the patients to the pharmacists, the caregivers, and the healthcare providers. As we launch the Vial Combinator, we renew our commitment to connecting these dots and advancing the state of digital hematology.

Finally, a special thank you goes to Angela Kellum, PharmD at Tulane University’s Hemophilia Treatment Center, and her son, Samuel Kellum, Tulane University student, for their contributions to the Vial Combinator.