Dose standardisation of anticancer drugs

Pouliquen, Anne-Lise; Escalup, Laurence; Jourdan, Nathalie; Cottu, Paul; Faure, Pierre; Madelaine-Chambrin, Isabelle

doi:10.1007/s11096-010-9478-6

Cited by 34 publications

(49 citation statements)

References 24 publications

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“…Three doses were calculated for each patient: DoseBSA corresponding to standard dose (mg m −2 ) multiplied by individual BSA; DoseFIXED corresponding to standard dose (mg m −2 ) multiplied by mean BSA; DoseBAND corresponding to standard dose (mg m −2 ) multiplied by relevant BSA band value: respectively 1.55, 1.80, or 2.05 m 2 depending on which of the following three BSA bands: BSA<1.7 m 2 , 1.7 m 2 ⩽BSA<1.9 m 2 , or BSA⩾1.9 m 2 the BSA of the patient belongs to. Cutoff values for the BSA bands were inspired from a previous dose-banding methodology used by Pouliquen et al (2011).…”

Section: Methodsmentioning

confidence: 99%

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Dose banding as an alternative to body surface area-based dosing of chemotherapeutic agents

et al. 2012

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Background:Dose banding is a recently suggested dosing method that uses predefined ranges (bands) of body surface area (BSA) to calculate each patient's dose by using a single BSA-value per band. Thus, drugs with sufficient long-term stability can be prepared in advance. The main advantages of dose banding are to reduce patient waiting time and improve pharmacy capacity planning; additional benefits include reduced medication errors, reduced drug wastage, and prospective quality control. This study compares dose banding with individual BSA dosing and fixed dose according to pharmacokinetic criteria.Methods:Three BSA bands were defined: BSA<1.7 m2, 1.7 m2⩽BSA<1.9 m2, BSA⩾1.9 m2 and each patient dose was calculated based on a unique BSA-value per band (1.55, 1.80, and 2.05 m2, respectively). By using individual clearance values of six drugs (cisplatin, docetaxel, paclitaxel, doxorubicin, irinotecan, and topotecan) from 1012 adult cancer patients in total, the AUCs corresponding to three dosing methods (BSA dosing, dose banding, and fixed dose) were compared with a target AUC for each drug.Results:For all six drugs, the per cent variation in individual dose obtained with dose banding compared with BSA dosing ranged between −14% and +22%, and distribution of AUC values was very similar with both dosing methods. In terms of reaching the target AUC, there was no significant difference in precision between dose banding and BSA dosing, except for paclitaxel (32.0% vs 30.7%, respectively; P<0.05). However, precision was significantly better for BSA dosing compared with fixed dose for four out of six drugs.Conclusion:For the studied drugs, implementation of dose banding should be considered as it entails no significant increase in interindividual plasma exposure.

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Section: Methodsmentioning

confidence: 99%

“…Dose banding has recently been suggested to optimise chemotherapy preparation (Plumridge and Sewell, 2001; Pouliquen et al , 2011). Ranges (or bands) of BSA, and corresponding mid-points of each band are predefined.…”

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confidence: 99%

Dose banding as an alternative to body surface area-based dosing of chemotherapeutic agents

et al. 2012

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“…The rational application of personalized dose principle may reduce the anticancer drug expenditures (Mertens, & de Jongh, 2009). Some other possible saving approaches have been proposed, such as dose rounding to the nearest vial size (Dooley, Singh, & Michael, 2004), dose standardization of anticancer drugs (Pouliquen, Escalup, Jourdan, et al, 2011) and selecting the most convenient vial size. In this framework, a project of drug waste reduction was designed and launched at the end of 2015 in the Hematology Department of the University Hospital Center "Mother Teresa" Tirana.…”

Section: Introductionmentioning

confidence: 99%

Cost Savings as a Result of Bortezomib Vial Sharing in Albania

Rustemi

Malaj

Hoti

et al. 2018

ESJ

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The costs associated with current and emerging therapies, as well as supportive care, are significant and pose a tremendous financial burden to both patients and healthcare system. The objective of this study was to calculate the cost savings as a result of bortezomib vial sharing in the University Hospital Center “Mother Teresa” Tirana. This study was a retrospective analysis of the use of bortezomib in patients with multiple myeloma, using vial sharing technique to minimize wastage. The study has been conducted during the period January 1, 2015 to June 30, 2015 before vial sharing and January 1, 2016 to June 30, 2016 after vial sharing, thereby enabling us to share vial contents between patients. We compared the cost in euro for the treatment with bortezomib in order to determine the cost savings of vial sharing and cost-efficacy of individualised preparation. As a result, the cost savings for one cycle/patient using vial sharing was calculated 226.81 euro, a reduction of 25.96% compared to the period when we did not use vial sharing. During January 1, 2015 to June 30, 2015 the average treatment cost was calculated 873.36 euro/cycle/patient, compared with January 1, 2016 to June 30, 2016 when it was calculated 646.55 euro/cycle/patient. Due to cost savings of each treatment cycle we administered 62 individualised preparations of bortezomib more during January 1, 2016 to June 30, 2016 for the same budget allocated. The same approach should be adopted for other suitable drugs prepared in the University Hospital Center “Mother Teresa” Tirana.

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“…By agreement the mid-dose of a band is prepared. LDB has been adapted by many cancer groups, such as the Peninsula Cancer Network3 and the Scottish Oncology Pharmacy Group,4 and is being gradually implemented in many oncology centres 5…”

Section: Introductionmentioning

confidence: 99%

The impact of logarithmic dose banding of anticancer drugs on pharmacy compounding efficiency at Ghent University Hospital

et al. 2017

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BackgroundDose banding (DB) (dose rounding with predetermined variation with prescription) enables in-advance preparation of high-turnover anticancer drugs with potential benefit for pharmacy compounding work flow.ObjectivesTo analyse the impact of potential situations on the efficiency of DB in the pharmacy (safe and maximum storage), calculate preparation lead times and the potential full-time equivalent (FTE) benefit.MethodsCandidate intravenous anticancer drugs were selected for logarithmic DB according to prescribing frequency, infusion volume and stability (usage data 2015 of the tertiary Ghent University Hospital, Belgium). With a selected DB set already stored, a 2-week time study (April/November 2015) provided lead times (between prescription and transfer) for just-in-time and DB preparations. A ‘maximal’ storage (using all drugs with a relative incidence of ≥2% recurrent monthly prescription) and a ‘safe’ storage scenario (lowest monthly prescribing pattern) were used to calculate the potential future FTE change.ResultsMean lead times for DB storage and just-in-time preparation were 17.1 min (95% CI 13.5 to 21.0) and 26.5 min (23.3 to 29.8). For 21 164 yearly preparations with already 5292 in DB (25%), 11 157 and 6 862 could be batch-produced in advance in a maximum storage and safe storage scenario, respectively. The existing FTE in 2015 of 5.41 could then be reduced to 4.91 and 5.27.ConclusionFurther development of DB could contribute to pharmacy compounding efficiency.

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Dose standardisation of anticancer drugs

Abstract: Our study shows that dose standardisation is a help to optimise the productivity and improve the organisation of the preparation unit.

Cited by 34 publications

References 24 publications

Dose banding as an alternative to body surface area-based dosing of chemotherapeutic agents

Dose banding as an alternative to body surface area-based dosing of chemotherapeutic agents

Cost Savings as a Result of Bortezomib Vial Sharing in Albania

The impact of logarithmic dose banding of anticancer drugs on pharmacy compounding efficiency at Ghent University Hospital

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