Drug waste minimisation and cost-containment in Medical Oncology: Two-year results of a feasibility study
Open Access
- 1 April 2008
- journal article
- Published by Springer Science and Business Media LLC in BMC Health Services Research
- Vol. 8 (1), 70
- https://doi.org/10.1186/1472-6963-8-70
Abstract
Cost-containment strategies are required to face the challenge of rising drug expenditures in Oncology. Drug wastage leads to economic loss, but little is known about the size of the problem in this field. Starting January 2005 we introduced a day-to-day monitoring of drug wastage and an accurate assessment of its costs. An internal protocol for waste minimisation was developed, consisting of four corrective measures: 1. A rational, per pathology distribution of chemotherapy sessions over the week. 2. The use of multi-dose vials. 3. A reasonable rounding of drug dosages. 4. The selection of the most convenient vial size, depending on drug unit pricing. Baseline analysis focused on 29 drugs over one year. Considering their unit price and waste amount, a major impact on expense was found to be attributable to six drugs: cetuximab, docetaxel, gemcitabine, oxaliplatin, pemetrexed and trastuzumab. The economic loss due to their waste equaled 4.8% of the annual drug expenditure. After the study protocol was started, the expense due to unused drugs showed a meaningful 45% reduction throughout 2006. Our experience confirms the economic relevance of waste minimisation and may represent a feasible model in addressing this issue. A centralised unit of drug processing, the availability of a computerised physician order entry system and an active involvement of the staff play a key role in allowing waste reduction and a consequent, substantial cost-saving.This publication has 18 references indexed in Scilit:
- Flat‐Fixed Dosing Versus Body Surface Area–Based Dosing of Anticancer Drugs: There Is a DifferenceThe Oncologist, 2007
- Cancer Care, Money, and the Value of Life: Whose Justice? Which Rationality?Journal of Clinical Oncology, 2007
- Cost of Cancer Care: Issues and ImplicationsJournal of Clinical Oncology, 2007
- Do Oncologists Believe New Cancer Drugs Offer Good Value?The Oncologist, 2006
- What Is Targeted Therapy?Journal of Clinical Oncology, 2005
- Practitioners? sources of clinical information on complementary and alternative medicine in oncologySupportive Care in Cancer, 2004
- Undocumented drug utilization and drug waste increase costs of pediatric anesthesia careFundamental & Clinical Pharmacology, 2004
- Implications of dose rounding of chemotherapy to the nearest vial sizeSupportive Care in Cancer, 2003
- Economic benefit of a centralized reconstitution unit of cytotoxic drugs in isolatorJournal of Oncology Pharmacy Practice, 1996
- Eliminating Waste and Inefficiency Can Do Little to Contain CostsHealth Affairs, 1994