Background. Centralized compounding of cytotoxic drugs and radiopharmaceuticals exposes pharmacy staff to substantial toxicological and radiological risks. Robotic automation offers a technological response, though its clinical and economic value remains debated.



Methods. Quantitative narrative synthesis of published literature (2012–2025) on clinical performance, radiation safety, and pharmacoeconomic evaluation of robotic cytotoxic compounding systems (CytoCare, KIRO Oncology, PHARMODUCT, intelligent dispensing robots) and automated devices in radiopharmacy/nuclear medicine, including a dedicated search for evidence from Morocco and North Africa. Monetary figures are expressed in USD, with non-USD values converted using approximate average exchange rates.



Results. A systematic review/meta-analysis of 14 studies on robotic cytotoxic compounding reported failure rates of 0.9–16.75% (±5% accuracy threshold), consistent with a reduction from 12.5% to 0.9% in the pivotal study. A Thai economic evaluation reported a robotic unit cost of $15.3/dose versus $7.1 manually under underutilization; break-even was estimated at 41,802 doses standalone, falling by 5,122 doses when networked. The incremental benefit-cost ratio rose from 1.566 (single-site) to 3.018 (network); at full capacity, unit cost was projected to fall to $5.3, yielding $17,230 in total economic benefits. In China, robot-assisted vial-sharing reduced pharmaceutical waste by 59.08% (mass) and saved $20,840 (47.51% of waste cost). North American CSTD data showed savings exceeding $96,000 over seven weeks (~$700,000 annualized). In radiopharmacy, automated 18F-FDG injectors reduced hand exposure by 97.97–98.96%, eye-lens dose by 43.24%, and whole-body dose by 91.66%; an autonomous dose-transport robot in nuclear cardiology cut mean staff dose from 0.67 to 0.49 mSv (−27%). A Moroccan retrospective analysis (National Institute of Oncology, Rabat) found that, despite a higher initial investment ($2,934,098.74), automation reduced annual drug costs by 19.74% (−$41,228.27) and personnel costs by $48,073.35, with break-even projected within two years.



Conclusion. Evidence—now including the first North African university hospital data—consistently supports net benefits in compounding accuracy and staff radioprotection. Economic profitability depends heavily on activity volume and implementation scope, favoring a regional over isolated acquisition approach in Morocco.