A cost analysis study of the implementation of fixed-dosing of monoclonal antibodies in the Netherlands Cancer Institute

• Published in: International journal of clinical pharmacy Vol. 43; no. 1; pp. 181 - 190
• Main Authors: Heinhuis, Kimberley M., Barkman, Hannerieke J., Beijnen, Jos H., Hendrikx, Jeroen J. M. A.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-02-2021
• Subjects: Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal - economics; Antineoplastic Agents, Immunological - administration & dosage; Antineoplastic Agents, Immunological - economics; Cost-Benefit Analysis; Health Care Costs; Humans; Internal Medicine; Medicine; Medicine & Public Health; Neoplasms - drug therapy; Netherlands; Pharmacy; Research Article; Netherlands; Monoclonal antibodies; Oncology; Fixed-dosing; Cost analysis; Cancer
• ISSN: 2210-7703; 2210-7711
• DOI: 10.1007/s11096-020-01131-z

Background
There is a strong rationale for fixed-dosing of monoclonal antibodies in oncology. Although fixed-dosing of recently introduced monoclonal antibodies is well accepted, the rationale is also applicable for other monoclonal antibodies that already have been used for years, but are still body-size-based dosed in many hospitals. In the Netherlands Cancer Institute, Antoni van Leeuwenhoek (NKI-AVL), fixed-dosing has been implemented now for all monoclonal antibodies and, therefore, this site offers an ideal opportunity for a cost analysis study.
Objective
To investigate the financial impact of switching to fixed-dosing in the NKI-AVL.
Setting
The NKI-AVL.
Method
Information on the preparations of monoclonal antibodies was collected from August 2017 to February 2020. We compared the number of vials needed during preparation for fixed-dosing and body-size -based dosing strategies. The economic impact was calculated for 2 scenarios: scenario 1 assumed clustering of all preparations per day and scenario 2 assumed no clustering of preparations.
Main outcome measure
Number of saved vials and the correlating savings in health care costs.
Results
The implementation of fixed-dosing resulted in a substantial reduction in vials used for almost all monoclonal antibodies. The economic savings were calculated to be €0,8 and €3,1 million per year for scenario 1 and 2, respectively.
Conclusion
Fixed-dosing resulted in substantial savings in health care costs.