Leveraging Artificial Intelligence in
Hospital Pharmacy Practice: NCCS
Experience
Peter Yap
Pharmacy Practice Manager
27 June 2025
Artificial Intelligence (AI)
What is AI?
• Technology that enables computers and machines to simulate
human learning, comprehension, problem solving, decision making,
creativity and autonomy
What are the key aspects of AI?
• Mimicking human intelligence
• Learning and adaptation
• Problem solving and reasoning
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What is Artificial Intelligence?
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Artificial Intelligence
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Artificial Intelligence in Healthcare
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Artificial Intelligence in Pharmacy Practice
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Role of AI in Drug Discovery & Development
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AI-Driven Optimization of Cytotoxic
Drug Compounding: Reducing
Chemotherapy Wastage and
Promoting Sustainability in Healthcare
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Objective
• Reducing chemotherapy wastage
• Promoting sustainability in aseptic compounding practice
– Support the broader goal of green pharmacy, setting a new benchmark for
sustainable, safe and cost-effective drug compounding practices
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Objective
• The project’s value proposition is centered on delivering a smart
solution that promotes cost-efficiency, environmental sustainability,
and occupational safety within cytotoxic drug handling practices,
while advancing the broader goals of green pharmacy.
• This project aims to develop AI-driven algorithms to optimize drug
vial selection for robotic compounding.
➢ Screen for drug orders from prescribing system generated output
➢ For a selected drug, perfect the extraction of orders (≤12) for compounding
➢ Provide interactive data visualization incorporating heatmaps and charts of
total wastage plotted by drug, time-period and reasons for wastage.
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Background
• The use of cytotoxic drugs in healthcare is essential for the
treatment of cancers.
Increasing Need for a more efficient use
Rising chemotherapy
needs chemotherapy drug of chemotherapy drugs and a
and compounding more sustainable
costs compounding process
Drug wastage and its economic implications significantly
increase the cost of cancer care without adding any
incremental value to patients.
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Current Issues
• Current vial sharing and recycling practice is
prohibited with adoption of GMP standards.
• Need to reduce waste, improve resource
utilisation, and promote environmentally
sustainable healthcare practices.
• Need to support the broader goal of green
pharmacy.
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GMP Standards
• Pharmaceutical Inspection Co-Operative Scheme (PIC/s 9)
• Global initiative that aims to harmonise Good Manufacturing Practice
standards for medicinal products, promoting quality and safety in the
pharmaceutical industry
• Adapting it to hospital / ambulatory care setting
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Methodology
PHASE 1 PHASE 2
➢ The project extracted data on ➢ Development of algorithm-driven
cytotoxic drug preparation from June calculator was using iterative
2021 to February 2022 at Ambulatory Dynamic Programming.
Treatment unit in National Cancer
Centre Singapore (NCCS). ➢ The calculator receives new drug
orders from prescribing system
➢ A Proof-of-Concept (POC) ➢ Calculates optimised order list for
calculator was developed using drug
Microsoft Excel to assess
➢ Returns a list of prescribed dosages
chemotherapy wastage.
for preparation with zero waste
Chemotherapy wastage is the sum of
wastage in the preparation phase and ➢ Generates interactive data
actual wastage in the administration visualization charts
phase.
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Methodology
PHASE 3
Recent development in natural language processing (NLP) leveraging Transformer architectures
have reshaped data analysis.
➢ Platform creation and systems integration, exploring large language model (LLM)-
based platform to further perfect the selection of orders for compounding
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Results
• Between June 2021 and February 2022, a total of 52,748
chemotherapy preparations were made.
• Over 9 months, POC calculator recorded a total of
2,216,431 mg of drug wastage, costing S$ 2,047,949.
Cost of
No. of Amount Amount of
chemotherapy
preparations prescribed chemotherapy wastage
wastage
n mg mg $
All drugs (n=35) 52,748 28,552,830 2,216,431 2,047,949.07
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Results
• POC calculator successfully identified
significant chemotherapy wastage,
particularly among biologics (most
expensive wastage) and traditional Figure 1: Top three drugs in terms of cost of chemotherapy wastage.
chemotherapy drugs (highest volume
of wastage).
• Approximately 55% of the total cost of
chemotherapy wastage was
contributed by wastage in the
preparation phase.
Figure 2: Top three drugs in terms of amount of chemotherapy wastage.
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Results
• Algorithm-driven calculator prototype able to optimise order list for
zero wastage during production stage.
• The visualization tool facilitates analysis into specific areas of
concerns.
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Discussion – Overview of Solution
Solution 3-Phase Plan Impact/Outcomes ➢ Positive environmental impact in terms of
hazardous drug waste reduction of CO2
POC Waste prevention and emission and pharmaceutical material
An algorithm-driven waste reduction
avoidance
calculator to perfect ➢ Significant financial savings to
AI-Driven organisation
the selection of drug
Calculator Financial savings
orders for robotic ✓ Hazardous drug waste reduction of
compounding based Pilot 31.4 kg CO2e/year [NCCS]
on the prescribed Interactive data
✓ Pharmaceutical material waste
dosage, to reduce Validation of visualization
reduction of 196.9 kg CO2e/year
the amount of drug performance [NCCS]
wastage due to ✓ Savings of at least S$5.24
Onboarding Process optimisation
unused portions in million/year to NCCS
single/ multi-dose
System Workflow integration
vials. Achieving Triple Bottom Line
integration
without impact to clinical care
Scalability and operation.
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Discussion - Impact
• Phase 3 of project is ongoing - Solution is currently developed for Pharmacists and
Pharmacy Technicians working in cytotoxic compounding facility.
• The solution can potentially be used by all compounding facilities, where batch
production of prescribed doses of a drug is required. The proposed solution and platform
is developed to be discipline/specialty-agnostic, allowing quick scaling across different
user departments.
Figures
No. of beneficiaries that your profession/department
150,000 attendance/year
sees in a year at your institution:
No. of beneficiaries that the solution would benefit per 40,000 cases/year
year upon implementation: 100,000 chemo prep/year
No. of potential beneficiaries seen across SingHealth in
200,000 attendance/year
a year:
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Discussion - Impact
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Success Baseline (Q1, FY2021 to Q4, FY2023) Target Confirmed State
Indicators
Clinical Impacts
No clinical impact Zero clinical impact Target zero harm
Environmental Impacts
- Water Approximately 55% of the total cost of To achieve net carbon gain Achieve a net zero CO2e in the
- Electricity chemotherapy wastage was contributed by of at least 200 kg CO2e per Compounding Hub
- Carbon Emissions wastage in the preparation phase year.
- Waste [A project to determine carbon
Hazardous drug waste of 31.4 kg CO2e per
footprint in will be initiated.]
year
Pharmaceutical material waste of 196.9 kg
CO2e per year
Social Impacts
Staff satisfaction survey. Achieve >80% satisfaction Target <10% staff turnover rate
score.
Financial Impacts
Over 9 months, POC calculator recorded a total of To achieve 80% reduction of Target > 5% annual saving in
drug wastage costing S$ 2,047,949 drug wastage from baseline. operating expenses.
(Annualized~$2.7M). This translate to drug wastage
of <$540,000 pa.
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Conclusion
• Phase 1 & Phase 2 have identified critical gaps in chemotherapy
wastage
• Successful development of an algorithm-driven calculator that
maximizes drug orders for zero wastage
• Phase 3 is a work-in-progress leveraging cutting edge natural
language processing (NLP) and large language models (LLM) to
enhance platform integration and scalability
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Limitation
• Single centre study resulting in (?) external validity
• Affect ability to generalized the findings
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Next steps …..
• Dose banding (batch production)
• Dose rounding (to the nearest vial)
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Thank You
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