Cancer Therapy Dose-Rounding Lowers Costs

Research presented at the ASHP 2017 Midyear Clinical Meeting and Exposition found that the dose-rounding of certain monoclonal antibodies plus or minus 10% produced significant cost- and waste-savings.

Monoclonal antibodies are targeted therapies used in the cancer treatment armamentarium. They have the potential to reduce adverse events associated with standard chemotherapy regimens. Because the majority of monoclonal antibodies are branded, they often incur a significant cost burden.

Previous studies have shown costs-savings upward of $100,000 associated with dose-rounding strategies, with no adverse effects in patient care. Michael Bair, pharmacy student at Roseman University of Health Sciences, and colleagues sought to evaluate the potential cost- and waste-savings of a dose-rounding program to the nearest vial size over a 4-month study period.

The researchers rounded Rituxan (rituximab; Genentech), Avastin (bevacizumab; Genentech), Yervoy (ipilimumab; Bristol-Myers Squibb), and Erbitux (cetuximab; Lilly) to the next vial size by 5% to 10%, with changes noted in a documented spreadsheet that included prescribed dose, rounded dose, percent dose change, waste-savings in milligrams, and cost-savings. 

Mr Bair presented data on Avastin dose-rounding, which included documentation of 20 dose-rounding instances. Waste savings were observed in 70% of instances due to dose-rounding up, and 30% produced cost-savings by rounding down.

The total waste-savings was 435.5 mg, with a total cost-savings of $4766.38 over the study’s prescribed time period. This translated to a projected annual waste-savings of 2735 mg and annual cost savings of $24,703.61.

“This procedure is easily implemented and could be utilized at other institutions to help in reduction of cancer therapy cost and waste,” the researchers concluded.

—Cameron Kelsall