Cost savings from dose rounding of biologic anticancer agents in adults

Purpose: The purpose of this project was to determine the cost savings related to a dose-rounding process for adult biologic anticancer agents. Methods: Biologic anticancer agents prepared by the inpatient pharmacy were identified retrospectively through completed chemotherapy preparation checklists...

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Bibliographic Details
Published in:	Journal of oncology pharmacy practice Vol. 17; no. 3; pp. 246 - 251
Main Authors:	Winger, Brenda J, Clements, Elizabeth A, DeYoung, Jaculin L, O'Rourke, Timothy J, Claypool, Deborah L, Vachon, Steve, VanDyke, Thomas H, Zimmer-Young, Jennifer, Kintzel, Polly E
Format:	Journal Article
Language:	English
Published:	London, England SAGE Publications 01-09-2011 Sage Publications Ltd
Subjects:	Adult Age Factors Antineoplastic Agents - administration & dosage Antineoplastic Agents - economics Attitude of Health Personnel Biological Products - administration & dosage Biological Products - economics Cancer Cost Savings Drug Costs Drug Dosage Calculations Drug dosages Drug therapy Guideline Adherence Health care expenditures Health Knowledge, Attitudes, Practice Hospital Costs Humans Medication Therapy Management - economics Pharmacy Service, Hospital - economics Practice Guidelines as Topic Retrospective Studies Time Factors Utah Utah admixture biologic therapy cost
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Summary:	Purpose: The purpose of this project was to determine the cost savings related to a dose-rounding process for adult biologic anticancer agents. Methods: Biologic anticancer agents prepared by the inpatient pharmacy were identified retrospectively through completed chemotherapy preparation checklists and medication orders on file in the pharmacy or by the clinical pharmacist for adult oncology from the medical records of patients in her practice. The specific products screened for evaluation were aldesleukin, bevacizumab, cetuximab, denileukin diftitox, gemtuzumab, rituximab, and trastuzumab. Data collected included drug name, ordered dose, rounded dose, and product vials not wasted. Specific drug costs were provided by the department’s purchasing office. The project was reviewed and approved by the institutional review board to allow retrospective data collection from patient records. Cost savings were evaluated retrospectively for the time period of January 1, 2005 through March 31, 2005. Results: One hundred and twenty-six orders for biologic anticancer agents were processed by the pharmacy department during the 3-month time period of data collection. Dose rounding could reduce drug wastage for 42% of these orders. Potential cost savings from dose rounding was $24,434 for the 3-month interval evaluated. However, nonadherence to dose rounding for 29 rituximab orders decreased the actual cost savings to $15,922. Individual staff education was reinforced to address nonadherence. Conclusion: Routine dose rounding of biologic anticancer agents to an amount within 10% of the ordered dose achieved cost savings through reduction of drug wastage at our institution.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1078-1552 1477-092X
DOI:	10.1177/1078155210366171