Cancer chemotherapy drug wastage in a tertiary care hospital in India—A 3‐month prospective and 1‐year retrospective study

Gopisankar, MG; Wahlang, Julie Birdie; Jagtap, Vikas; Sarkar, Chayna; Devi, L Purnima; Harris, Caleb

doi:10.1111/bcp.14064

Cited by 10 publications

(20 citation statements)

References 17 publications

(9 reference statements)

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“…Nonetheless, the study has demonstrated substantial cost savings due to vial-sharing, which supports other studies that encourage the use of vial-sharing to reduce chemotherapy wastage. 9,12,25…”

Section: Discussionmentioning

confidence: 99%

“…8 Another study found the cost of chemotherapy wastage to be 17.14% of the total expenditure on drugs in 1 year. 9 The cost savings generated from addressing chemotherapy wastage can be diverted to improve patients’ access to novel chemotherapy drugs and enhance patient care, therefore highlighting the need to reduce chemotherapy wastage. 10…”

Section: Introductionmentioning

confidence: 99%

“…11 There is a need to explore the development of a chemotherapy waste calculator that can account for other reasons for wastage, such as wastage produced during the preparation phase due to improper vial size. 8,9,12…”

Section: Introductionmentioning

confidence: 99%

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Quantifying chemotherapy wastage in an ambulatory cancer centre in Singapore

Chan

Leow

Poh

et al. 2023

J Oncol Pharm Pract

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Introduction To ensure the efficient use of chemotherapy drugs, chemotherapy wastage is an area that can be investigated. This study aims to quantify current parenteral chemotherapy wastage and estimate parenteral chemotherapy wastage when dose banding is executed, using a chemotherapy wastage calculator in an ambulatory cancer centre. The study also examines the variables that significantly predict the total cost of chemotherapy wastage, investigates the reasons for wastage, and explores opportunities to reduce wastage. Methods Data were collected from the pharmacy in National Cancer Centre Singapore over 9 months retrospectively. Chemotherapy wastage is the sum of wastage in the preparation phase and potential wastage in the administration phase. The calculator was created using Microsoft Excel and generated chemotherapy wastage in terms of cost and amount (mg) and analysed the reasons for potential wastage. Results The calculator reported a total of 2.22 million mg of chemotherapy wastage generated over 9 months, amounting to $2.05 million (Singapore Dollars, SGD). Regression analysis found that the cost of drug was the only independent variable that significantly predicted the total cost of chemotherapy wastage ( P = 0.004). The study also identified low blood count (625 [29.06%]) as the top reason for potential wastage and no-show ($128,715.94 [15.97%]) as the reason that incurred the highest cost of potential wastage. Conclusion The pharmacy has generated a considerable amount of chemotherapy wastage over 9 months. Interventions in both the preparation and administration phases are required to reduce chemotherapy wastage. The use of the chemotherapy wastage calculator in pharmacy operations could guide efforts to reduce chemotherapy wastage.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Quantifying chemotherapy wastage in an ambulatory cancer centre in Singapore

Chan

Leow

Poh

et al. 2023

J Oncol Pharm Pract

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“…Measures for drug wastage are one of the most important strategies for containing this cost. One of the most common causes of drug wastage is the discarding of residual anticancer drugs after preparation . Application of dose rounding of chemotherapy to the nearest vial size and drug vial optimisation, which allows the use of single‐use vials for multiple patients, are effective measures for minimising leftover anticancer drugs …”

Section: Discussionmentioning

confidence: 99%

“…One of the most common causes of drug wastage is the discarding of residual anticancer drugs after preparation. 8 Application of dose rounding of chemotherapy to the nearest vial size and drug vial optimisation, which allows the use of single-use vials for multiple patients, are effective measures for minimising leftover anticancer drugs. 4,9,10 However, in our hospital, there were 18 cases (18 patients) in 2016 (before introduction of the present protocol) in which anticancer drugs were discarded after preparation.…”

Section: Discussionmentioning

confidence: 99%

Implementation of a standardised pharmacist check of medical orders prior to preparation of anticancer drugs to reduce drug wastage

et al. 2019

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Background The increasing cost of anticancer drugs is now being recognised as a global problem, and measures against drug wastage are among the most important cost containment strategies for anticancer drugs. Objective When blood examination results or changes to a patient's condition necessitate dose reduction or discontinuation of anticancer drugs after their preparation, the compounded anticancer drugs are discarded. To reduce anticancer drug wastage after preparation, we developed a protocol that set the eligibility, start of treatment, dose reduction and discontinuation criteria for injectable anticancer drugs and assessed the effect of pharmacists' checks of these criteria based on the present protocol prior to preparation of injectable anticancer drugs. Method Observations before and after introduction of the protocol were conducted at Gifu University Hospital. We recorded the number, type and cost of anticancer drugs discarded after preparation and the reason for discarding these drugs in our dedicated database. Results Checking the criteria for anticancer drug administration before preparation significantly reduced the rate at which anticancer drugs within a chemotherapy cycle were discarded after preparation compared with that prior to the protocol's introduction (0.367% [18/4909] vs 0.032% [2/6248], P < .001). Additionally, the total cost of anticancer drugs discarded after preparation was reduced from JPY 2 041 786 (USD 18 562) to JPY 398 414 (USD 3622). Conclusion Pharmacists' checks of the eligibility, start of treatment, dose reduction and discontinuation criteria for anticancer drugs based on the present protocol prior to preparation of injectable anticancer drugs was useful for reducing drug wastage after preparation.

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