Variability introduces risk into pharmacy workflows. Equipment and process standardization can help mitigate variability and risk.
At a glance:
Cold storage failure delays patient treatment, reduces staff productivity, and creates non-recoverable financial loss for health systems.
Process and equipment standardization has been shown in other hospital domains to limit risk and cost.
Standardizing cold storage may help reduce overall risk exposure in health system pharmacy workflows.
Advancements in biologics and personalized medicine therapies over the past decade has improved patient outcomes across several chronic, autoimmune, and other diseases.
These advances come at a cost. Non-retail inflation-adjusted drug spend in the U.S. has gone from $146B in 2016 to $182B in 2024 while median operating margins have shrunk from 2.7% in 2016 to 1.3% in December of 2025.
Pharmacy leaders face the difficult task of managing patient outcomes and drug expenditures under increasing budget pressure. Under these conditions, efficiency and risk mitigation become the primary responsibilities of health system pharmacy executives.
Complete elimination of risk is not possible, but awareness of risk is the first step toward mitigation. Below are four critical pharmacy KPIs that may be vulnerable to cold storage failure.
In each section, we will define the KPI, describe its importance in the pharmacy workflow, and identify ways in which cold storage failure may influence it.
1. Medication Waste Rate
What it is: the proportion of pharmaceutical products that are dispensed, prepared, or purchased but never fully consumed, or that expire before use.
Why it matters: wasted medications often result in non-recoverable financial loss for health systems and may incur additional disposal cost. In a survey conducted by the American Society of Health-System Pharmacists, roughly 19%* of surveyed hospitals experienced temperature excursions that resulted in non-recoverable financial loss.
How cold storage contributes: variances in product quality, age, maintenance, and user familiarity can all contribute to preventable cold storage failure
2. Medication Wait Time
What it is: the total duration of time a patient spends waiting for a prescription to be filled, or for a medication to be administered.
Why it matters: medication wait times have a documented impact on patient satisfaction, reduced adherence, hospital performance. Industry benchmarks for medication wait time vary between 28-80 minutes depending on hospital and prescription type.
How cold storage contributes: regulations require immediate response to temperature excursions that includes quarantine and labeling of exposed medication, documentation, and manufacturer consultation to determine viability. These procedures often take hours, even days. Replacement medications must be sourced if not kept on site, creating delays in medication wait time.
3. Drug Spend
What it is: the total expenditure on medications (inpatient and outpatient) within a health system.
Why it matters: drug spend is often one of the largest hospital cost centers. Industry-wide US estimates in 2023 were $115B for non-federal hospitals, putting average annual drug spend for non-federal hospitals around $20M ($115B/5,886 non-federal hospitals).
How cold storage contributes: temperature excursions that create non-recoverable loss incur both the cost of the lost medication and the cost of replacement, increasing system drug spend. While hospital-specific metrics are difficult to find, the IQVIA Institute estimates annual losses around $35B due to temperature failure across the biopharma industry cold chain.
4. Staff Productivity
What it is: the ratio of work outputs (e.g., doses dispensed, orders verified, clinical interventions) to labor inputs (e.g., worked hours, full-time equivalents).
Why it matters: staffing shortages continue to plague the healthcare industry. According to ASHP, 88% of hospitals report a shortage of experienced pharmacy technicians and 92% report shortages of technicians with sterile compounding experience. Critically understaffed pharmacies demand optimum staff productivity.
How cold storage contributes: the temperature excursion response SOP diverts personnel resources from critical pharmacy tasks to quarantine, label, document, and consult with manufacturers.
Mitigating Cold Storage Risk
Risk is a function of variability. Hypothetically, if all variables in a situation could be completely controlled, risk could be eliminated.
Unfortunately, control of all variables is not possible. Risk-mitigation, then is the control of as many variables as it is possible or financially feasible to control
Many hospitals already standardize procedures and some types of equipment for precisely this reason. In fact, standardization of both equipment and processes has been shown to reduce cost in a wide range of hospital domains including a 20% reduction in surgical supplies cost, a decrease in readmission rates and variation in quality, and a 51.6% to 76.3% reduction in hospital-acquired pressure injuries (HAPIs).
While no study has investigated the direct impact of cold storage standardization, the underlying principle – reducing risk by controlling variances in equipment quality and performance – hold true.
In addition to risk mitigation, standardization can provide benefits in pricing, maintenance continuity, vendor management, and fleet monitoring.
System-Wide Pharmacy Solutions
Pharmacy leaders considering cold storage standardization should examine several factors including:
• Portfolio breadth – does the vendor have the required products to support the pharmacy continuum of care?
• Service capability – does the vendor offer maintenance, preventive
maintenance, and service solutions?
• Product quality – does the vendor have a reputation for designing and
manufacturing high-quality products?
Helmer® Scientific boasts a portfolio of pharmacy cold storage solutions designed to support the full spectrum of health system pharmacy workflows from cleanrooms to medication management designed to stand up to the rigors of daily use.
If you would like to explore standardization for your system’s pharmacy cold storage, visit our IHN Solutions page or contact your local representative.
*Calculated. 75% reported temperature excursion. Of those, 50% reported quarantine. Of those, 50% resulted in financial loss. 100*.75*.5*.5=18.75
