Impact of dose rounding of cancer therapy on cost avoidance: a pilot study

Ibrahim, Nagwa

doi:10.7175/fe.v14i4.658

Cited by 10 publications

(13 citation statements)

References 13 publications

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“…11,[32][33][34] However, dose rounding for high cost cytotoxic drugs especially targeted therapies such as monoclonal antibody cytotoxic drugs is not commonly adopted despite the fact that up to 45% of the cost of these biologic cytotoxic drugs could be saved by rounding dose according to the nearest standard vial size (as long as the dose was within 10% of calculated dose). 6,33,35 Therefore, the practice of dose rounding of cytotoxic drug according to standard vial size could be employed by Oncology Pharmacy to reduce the expenditure on cytotoxic drug while providing quality cancer treatment.…”

Section: Rising Global Cancer Burden -Existing and Potential Strategimentioning

confidence: 99%

Parenteral cytotoxic drug wastage at a tertiary hospital in Kuala Lumpur: How much and why?

Ang

Cheah

Abdullah

et al. 2019

J Oncol Pharm Pract

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Purpose To identify the cost and reasons of returned parenteral chemotherapy regimens at a tertiary hospital in Kuala Lumpur, Malaysia. Methods Data were retrospectively extracted from all the Chemotherapy Return Forms in 2016, which is a compulsory documentation accompanying each return of parenteral chemotherapy regimen. The following data were extracted: patient’s diagnosis, gender, location of treatment (i.e. ward/daycare clinic), start date of chemotherapy regimen, type of cytotoxic drug returned, dose of cytotoxic drug returned, number of cytotoxic drug preparations returned and reason for return as well as whether the returned cytotoxic drug preparations could be re-dispensed. The cost of wastage was calculated based on the cost per mg (or per unit) of the particular returned cytotoxic drug. Results One hundred and fifty-nine cases of returned chemotherapy regimen comprising of 231 parenteral cytotoxic drug preparations were analysed. The total cost of returned chemotherapy regimen for 2016 was €3632, with €756 (20.8%) worth of chemotherapy regimens returned due to preventable reasons and €2876 (79.2%) worth of chemotherapy regimens returned due to non-preventable reasons. Approximately 50% of cases returned chemotherapy regimen were due to deterioration of patient’s clinical condition and another 24.5% of cases of returned chemotherapy regimen were attributed to adverse drug reactions. Conclusion Wastage associated to non-preventable reasons such as adverse drug reactions and preventable causes like refusal of patients can be further reduced by using newer healthcare innovations and establishment of written institutional protocols or standard operating procedures as references for in-charge healthcare personnel when cytotoxic drug-related issues occur. Adoption of cost-saving strategies that have been proven by studies could further improve current cost containment strategies.

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Section: Rising Global Cancer Burden -Existing and Potential Strategimentioning

confidence: 99%

Parenteral cytotoxic drug wastage at a tertiary hospital in Kuala Lumpur: How much and why?

Ang

Cheah

Abdullah

et al. 2019

J Oncol Pharm Pract

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“…1 A substantial proportion of these expenditures stems from the incorporation of these expensive novel oncology drugs into clinical practice. 2 One method of containing costs in adult oncology is the utilization of dose rounding cytotoxic chemotherapy and biologic agent doses to the nearest vial size. 2,3…”

Section: Introductionmentioning

confidence: 99%

“…Most dose-rounding protocols address traditional chemotherapy and support rounding within 5% to 10% of the ordered dose. 2,3 This practice is based on variances within dose calculations, pharmacokinetic principles, and clinical evidence. Traditional chemotherapy doses are most often calculated using body surface area (BSA).…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the dosing strategies of biologic agents and the theoretical impact of dose rounding

Lindsey

Parsons

Figg

et al. 2016

J Oncol Pharm Pract

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Introduction Monoclonal antibodies possess unique pharmacokinetic properties that permit flexible dosing. Increased use and high costs of these medications have led to the development of cost-containing strategies. This study aims to quantify the cost savings and clinical impact associated with dose rounding monoclonal antibodies to the nearest vial size. Methods This study was a single-arm, retrospective chart review assessing all monoclonal antibody doses dispensed at an outpatient community infusion center associated with an academic medical center between August 2014 and August 2015. All monoclonal antibody doses were reviewed to determine the cost of drug wasted using two methods. The waste-cost analysis described the amount of drug disposed of due to the use of partial vials. The theoretical dose savings described potential cost avoidance based on rounding the ordered dose to the nearest vial size. The theoretical rounded dose was compared to the actual ordered dose to explore clinical implications. Results A total of 436 doses were included. Of these, 237 were not rounded to the nearest vial size and included in the analysis. The cost of waste associated with these doses was $108,013.64 using actual wholesale price. The potential cost avoidance associated with the theoretical dose calculation was $83,595.53. Rounding these doses to the nearest vial size resulted in a median 6.7% (range, 1.4-20%) deviation from ordered dose. Conclusions Rounding monoclonal antibodies to the nearest vial size could lead to significant cost and waste savings with minimal deviation from the actual ordered dose.

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“…Brenda et al 5 found that dose rounding could reduce drug wastage for up to 42% and resulted in a potential cost savings of $24,434 for 3-month interval. In another study done by Nagwa Ibrahim, 7 dose rounding of anti-cancer agents may save around $192,800 per year. Our study reveals that the projected annual saving was calculated to be SR 176,651.40 for 5% rounding limit and SR 637,890.00 for 10% rounding which will account to an estimate of SR 814,514.40 ($217,204) of drug wastage per year.…”

mentioning

confidence: 99%

Rounding Down Chemotherapeutic Agents to the Nearest Vial Size as a Cost Containment Measure

Al-Olah¹,

Al-Qhtani²,

Waheeby³

et al. 2017

Cancer Stud Mol Med Open J

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Impact of dose rounding of cancer therapy on cost avoidance: a pilot study

Cited by 10 publications

References 13 publications

Parenteral cytotoxic drug wastage at a tertiary hospital in Kuala Lumpur: How much and why?

Parenteral cytotoxic drug wastage at a tertiary hospital in Kuala Lumpur: How much and why?

Evaluation of the dosing strategies of biologic agents and the theoretical impact of dose rounding

Rounding Down Chemotherapeutic Agents to the Nearest Vial Size as a Cost Containment Measure

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