Pharmacy500 Closed System Drug-Transfer Devices (CSTDs) Report

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MAR 2025

SUPPLY CHAIN TEARDOWN

Closed System

Drug-Transfer Devices

(CSTDs)

Product Displayed: EQUASHIELD®

©2025 RXinsider | RXinsider Market Intelligence Group | 2025

Alexa DiLuca

Marketing Manager

Michael McEwen

Pharmacy500 Market Analyst

michael.mcewen@rxinsider.com

Gregory Cianfarani, RPh

Founder & CEO

MEET THE

MARKET INTELLIGENCE TEAM

About RXinsider

Founded in 1999, RXinsider is a pharmacist-founded marketing/

communications (MARCOM) and market intelligence (INTEL) company

focused on pharmacy operations and the companies supporting

dispensing pharmacies. Through our publications, digital platforms,

market research, and training resources, RXinsider educates pharmacy

management and industry professionals on the products, services,

and trends that impact pharmacy operations across the supply chain.

RXinsider’s Market Intelligence (INTEL) Group performs market research

on the pharmacy operations supply chain and the Pharmacy500

companies. Through our weekly reports, digital awareness, and online

training, the INTEL Group educates Pharmacy500 professionals and

pharmacy management on the products and services impacting

pharmacy operations.

Lexi Cianfarani

Pharmacy500 Market Analyst

lexi.cianfarani@rxinsider.com

Jeff Rackliff

Pharmacy500 Market Analyst

jeff.rackliff@rxinsider.com

Emma Cidade

Pharmacy500 Market Analyst

emma.cidade@rxinsider.com

Report Lead

Jeff Rackliff

©2025 RXinsider | RXinsider Market Intelligence Group | 2025

A 2025 Breakdown of

Closed System Drug-

Transfer Devices (CSTDs)

The objective of this report is to educate Pharmacy500

professionals, pharmacy leadership, and other stakeholders on

key trends within the compounding supply chain as it relates to

Closed System Drug-Transfer Devices (CSTDs).

Table of Contents

• Introduction .................................................... 2-3

• CSTDs Overview & Key Features ...................4

• CSTDs Company Listing .................................5

• Company Location & Practice Settings ........6

• CSTDs Products ............................................ 7-9

• Conferences, Trade Shows & Meetings .....10

• End Users & Buyer Personas ........................11

• Public Companies & Stock Performance ....12

• References .......................................................13

• Pharmacy500 Companies ......................14-18

CSTDs Overview

Pharmacy Closed System Drug-Transfer Devices (CSTDs) are

specialized mechanical devices designed to prevent the escape

of hazardous drug vapors, aerosols, and liquids during drug

preparation, transfer, and administration. They are used in pharmacy

and healthcare settings to ensure the safe handling of hazardous

drugs, protecting healthcare workers, patients, and the environment

from exposure. CSTDs are a critical component of safety protocols

in pharmacy practice, ensuring a safer working environment and

minimizing risks associated with the handling of hazardous drugs.

National Institute for Occupational Safety and Health (NIOSH) definition:

Closed System Drug-Transfer Device (CSTD): a drug transfer device that

mechanically prohibits the transfer of environmental contaminants into

the system and the escape of hazardous drug or vapor concentrations

outside the system.

Closed System: a device that does not exchange unfiltered air or

contaminants with the adjacent environment.

©2025 RXinsider | RXinsider Market Intelligence Group | 2025

Key Features of CSTDs

1. Closed System Design: A completely sealed system

that prevents contamination by ensuring no venting or

leakage of drug or vapor into the environment during

drug manipulation.

2. Dual Protection: Prevents:

• The escape of hazardous drug particles, vapors,

or aerosols into the environment.

• Contaminants from entering the drug vial or

container, maintaining sterility.

3. Regulatory Standards: Required under USP <800>

guidelines for the preparation and administration of

hazardous drugs to minimize occupational exposure.

4. Mechanisms of Action: Includes features like:

• Mechanically Closed Systems: Physically

block the transfer of contaminants or escape of

hazardous materials.

• Air-cleaning Closed Systems: Use filters or

membranes to clean air exchanged during drug

manipulation.

5. Applications: Used for handling hazardous

medications such as chemotherapy drugs, biologics,

and other cytotoxic agents in sterile compounding,

administration, and waste management.

6. Integration with Existing Systems: Compatible

with syringes, vials, and IV bags, and often used in

conjunction with compounding aseptic containment

isolators (CACIs) or biological safety cabinets (BSCs).

7. Benefits:

• Reduces healthcare worker exposure to

hazardous drugs.

• Maintains medication integrity and sterility.

• Enhances compliance with occupational and

environmental safety regulations.

8. Components

• Vial Adapter

• Syringe Adapter

• IV Bag / Spike Adapter

The “Pharmacy500” are 500 businesses and associations that significantly

impacted the business operations of dispensing pharmacies in the U.S. over

the previous year. The six companies listed below are the companies within

the 2025 Pharmacy500 that make up the Compounding: Closed System

Drug-Transfer Devices (CSTDs) Supply Chain Category. For Pharmacy500

criteria and details, please visit www.RXinsider.com/Pharmacy500.

©2025 RXinsider | RXinsider Market Intelligence Group | 2025

Pharmacy500 CSTDs Companies

©2025 RXinsider | RXinsider Market Intelligence Group | 2025

Companies by Location

The following shows the applicable practice settings for CSTDs.

Practice Setting Breakout

NUCLEAR

MANAGED CARE / PBM

HOME INFUSION / COMPOUNDING

LONG TERM CARE

SPECIALTY

HOSPITAL / HEALTH SYSTEM

COMMUNITY / RETAIL

©2025 RXinsider | RXinsider Market Intelligence Group | 2025

CSTD Products

OnGuard® 2

• OnGuard® 2 is a closed system transfer device (CSTD) that

incorporates all of the current advantages of OnGuard, while

offering upgraded materials and improved usability. OnGuard

2 is designed to keep healthcare professionals safe when

handling hazardous drugs. OnGuard 2 includes a complete

portfolio of products for most handling protocol.

BD PhaSeal™ Optima System

• The BD PhaSeal™ System pioneered the category of closed-

system drug-transfer devices (CSTDs) to help protect the

pharmacists and clinicians who prepare and administer

hazardous drugs. Twenty years later, we turned to healthcare

professionals like you for feedback and guidance to optimize

its every component. The result is the BD PhaSeal™ Optima

System—a next-generation, user-tested CSTD solution that

advances hazardous drug safety.

BD Texium™ System

• The centerpiece of the Texium™ System is the Texium™ Closed

Male Luer. This is an airtight, leak-free, and drip-free closed

system drug transfer device (CSTD) and when paired with a

SmartSite™ Needle-free Connector, mechanically prohibits the

transfer of environmental contaminants into the system and the

escape of drug vapor concentrations outside the system.

BD SmartSite™ Needle-free Connector

• Allows closed system administration of medication when used

with a Texium™ closed male luer.

©2025 RXinsider | RXinsider Market Intelligence Group | 2025

Halo® Closed System Transfer Device

• Halo® Closed System Transfer Device has been evaluated for

vapor and fluid containment, prevention of microbial ingress,

pressure test and drug resistance. Each Halo® component is

airtight and leak proof, intuitive and easy to use, compatible and

efficient.

EQUASHIELD®

• EQUASHIELD® is the industry leading CSTD, known for its

closed-back syringes and advanced safety measures to prevent

contamination and vapor escape in handling hazardous drugs.

ChemoLock™ Needlefree Closed System

Transfer Device (CSTD)

• The ChemoLock CSTD’s mechanically closed, needlefree

system is designed to help prohibit the escape of hazardous

drugs and vapor while maintaining the sterility of the drugs

during preparation.

ChemoClave™ Needlefree Closed System

Transfer Device (CSTD)

• Maintain a needlefree closed system to help minimize exposure

to hazardous drugs and comply with USP <800>. Familiar luer-

based CSTD, bonded to help you improve workflow efficiency

and prevent the risk of exposure due to accidental disconnects.

Arisure® Closed System Transfer Device

• The Arisure CSTD keeps you and your team safe so you can

quickly and efficiently compound the right drug and the right

dose with the least amount of disruption to your workflow.

©2025 RXinsider | RXinsider Market Intelligence Group | 2025

10

©2025 RXinsider | RXinsider Market Intelligence Group | 2025

Conferences, Trade Shows & Meetings

The following identifies the major

national pharmacy conferences

at which Pharmacy500 CSTD

companies exhibited in 2024.

The top three conferences in

2024 were ASHP Midyear, ASHP

Pharmacy Futures, and NHIA. For

the past two years, all six of the

Pharmacy500 CSTD companies

have exhibited at ASHP Midyear.

Top Three Conferences

ASHP Midyear

ASHP Pharmacy Futures

NHIA

2022

2024

2023

2022

2024

2023

2022

2024

2023

PHARMACY

FUTURES

MIDYEAR

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

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