Effect of Standardized Infliximab Dose Rounding on an Outpatient Infusion Center

Park, Jiyeon Joy; Boutillier, Lauren; Cruz, Joseph E.; Joung, GaEun; Nemeth, Jeffrey

doi:10.18553/jmcp.2018.24.10.1028

Cited by 2 publications

(10 citation statements)

References 4 publications

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“…In addition to cost saving, the present study revealed that the dose-rounding strategy saved an average time of 7 min per preparation episode. It has been shown that the standardization of infliximab dose rounding resulted in reduced time consumption for order verification on an average of 8–10 min [16].…”

Section: Discussionmentioning

confidence: 99%

“…Dose rounding seems more relevant for prescriptions supplied in single-use vials as a preservative-free formulation [15]. Interestingly, in one institution, dose rounding has become a part of clinical practice to avoid wastage through partially used vials [16]. There are a limited number of studies have been conducted both internationally and locally.…”

Section: Introductionmentioning

confidence: 99%

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Dose Rounding and Cost Reduction of Anticancer Agents at King Fahad Medical City, Saudi Arabia: A 1-Year Feasibility Study

Bany Hamdan,

AlBanyan,

Alwuhayd

et al. 2023

Saudi J Health Syst Res

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Introduction: The exponential increase in the price of anticancer drugs has warranted looking for a cost-saving measure to counter their price rise. We aim to study the impact of dose rounding of biological and anticancer agents within a range of 10% of the ordered dose. Method: The study involved patients treated with anticancer agents between January 2018 and December 2018 at King Fahad Medical City’s (KFMC) comprehensive cancer center. An anticancer medication database was created for data collection and processing. All the eligible orders were processed by hematology and oncology physicians. A performance improvement methodology was used. The dose rounding was based on the patient’s preprinted order and the nearest available vial size. The potential impact on cost was measured in Saudi Riyals (SAR). Descriptive statistics were applied for data analysis and interpretation of the results. Results: A total of 26 anticancer medications were used for treating cancer patients, and 208 prescriptions were found to be eligible for dose rounding. Brentuximab was among the drugs, showing the highest cost saving at an estimated 20,600 SAR. In addition to reducing wastage and cost of medications, 7 min were saved per preparation episode in the post-intervention period. Conclusion: Data reflected that dose rounding of chemotherapy and biological agents up to a limit of 10% is a feasible approach and could potentially save extra cost and wastage of medications in the comprehensive cancer center of KFMC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dose Rounding and Cost Reduction of Anticancer Agents at King Fahad Medical City, Saudi Arabia: A 1-Year Feasibility Study

Bany Hamdan,

AlBanyan,

Alwuhayd

et al. 2023

Saudi J Health Syst Res

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“…2 This study focused on potential cost savings in oncology patients, however, many chemotherapy and biotherapy agents have non-oncologic indications that could offer more robust cost savings potential to a healthcare institution or system. 8 The intent of therapy may affect the willingness of providers to allow dose-rounding. Field and colleagues surveyed oncologists and found that approximately 77.8% were more comfortable with rounding within 10% of the originally intended order for palliative therapy in metastatic cancer patients versus those with curative intent.…”

Section: Discussionmentioning

confidence: 99%

“…3 Within these studies, the potential cost savings for biotherapies is more as they often have higher costs and are given for longer periods of time compared to conventional chemotherapy agents. [4][5][6][7][8][9][10][11][12][13][14] The goal of dose-rounding and dose-banding is to standardize the dosing of pharmacologic therapy given to patients and to decrease the financial burden for patients and healthcare systems alike. 15,16 Dose-rounding consists of increasing or decreasing a medication dose by an acceptable percentage value to the nearest vial size, while dose-banding establishes a set numerical value within a range of possible doses.…”

Section: Introductionmentioning

confidence: 99%

“…The second is improving the efficiency of medication ordering by a provider and order verification by a pharmacist. 8,13,17 Finally, these rounded or set values are easier to convert to measurable volumes during production of the final product which improves medication safety. 7,[14][15][16] Most agents utilized in oncology patients are available only as single-dose vials (SDV), which significantly limits the time in which the entire vial can be used.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of potential cost savings through chemotherapy and biotherapy dose-rounding at a pediatric institution

Graff,

Cramer,

Kolb

et al. 2023

J Oncol Pharm Pract

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Introduction Rapidly increasing costs of medication acquisition can pose a challenge for health-system pharmacy budgets. The impact of dose-rounding in a pediatric oncology population has not previously been well documented and a retrospective review was undertaken to quantify the potential cost benefits. Methods A retrospective chart review of patients with an oncologic diagnosis was performed for cytotoxic agents, asparaginase products, and biotherapy administered between January 1, 2014, and December 31, 2017. In the analysis, orders that could be rounded down to the nearest vial size by 5 or 10% were included. Medication pricing information was based on wholesale acquisition cost (WAC) and was provided by the Department of Pharmacy. Cost savings per medication were determined by multiplying the WAC of the medication by the number of vials saved. Results Over a 4-year span, 347 patients were evaluated and 552 out of a possible 3110 orders (17.7%) met criteria for a theoretical cost savings of approximately $1,126,000 (∼$3200 per patient). Rounding down doses by up to 5% resulted in a potential savings of about $529,000. When rounding was extended to 5–10% of the originally ordered dose, an additional $597,000 of approximate cost savings could have been realized. The medications with the largest impact on cost savings were rituximab, pegaspargase, and erwinia asparaginase. Conclusions For pediatric oncology patients, there exists a unique potential cost savings opportunity if doses are rounded down within 5 or 10% of the originally ordered weight-based or body surface area-calculated dose.

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Effect of Standardized Infliximab Dose Rounding on an Outpatient Infusion Center

Cited by 2 publications

References 4 publications

Dose Rounding and Cost Reduction of Anticancer Agents at King Fahad Medical City, Saudi Arabia: A 1-Year Feasibility Study

Dose Rounding and Cost Reduction of Anticancer Agents at King Fahad Medical City, Saudi Arabia: A 1-Year Feasibility Study

Evaluation of potential cost savings through chemotherapy and biotherapy dose-rounding at a pediatric institution

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