Background “Dose-banding” is a concept of standardising cytotoxic drugs that enables standardised rounded doses (SRD) to be prepared in advance, covering the most frequently prescribed doses rounded to ± 5%. Standard doses will be prepared in advance by batch in order to increase production capacity, at the same time regulating pharmacy workflow and reducing patient waiting time.
Purpose To identify anticancer drugs suitable for dose banding and to fix standardised doses.
Materials and methods The drugs were selected in accordance with several criteria: frequency of preparation, long-term physicochemical stability after reconstitution, repetition of the prescribed doses and opportunity for savings. The selected drugs were: carboplatin, cetuximab, cisplatin, cyclophosphamide, doxorubicin, 5-fluorouracil, gemcitabine, oxaliplatin, paclitaxel, rituximab, trastuzumab and vinorelbine. We established an inventory of the prescriptions retrospectively for a period of six months in order to highlight the most often prescribed doses. For the analysis, we fixed bands with a standard deviation of ± 5%, ± 7% and ± 10%.
Results Standardisation of doses of chemotherapy was deemed interesting if ≥60% of the doses were standardisable with a maximum of three SRD and a minimum of one delivery per week, in order to guarantee a good turnover of the batch. We added a maximum of 5% standard deviation to those three criteria, the deviation currently accepted among our medical staff. After analysing 3506 prescriptions, eight drugs were eligible: doxorubicin, 5-fluorouracil infusion, 5-fluorouracil pump, gemcitabine, paclitaxel, rituximab, trastuzumab and vinorelbine, with a percentage standardisation of 77% (SRD: 30 mg), 61% (SRD: 700–750-800 mg), 75% (SRD: 4000–4500-5000 mg), 72% (SRD: 1600–1800-2000 mg), 61% (SRD: 140–150-160 mg), 64% (SRD: 600–700-750 mg), 71% (SRD: 350–400-450 mg) and 62% (SRD: 40–50 mg) respectively.
Conclusions This preliminary study allows us to consider implementing the dose banding concept in order to optimise the anti-cancer chemotherapy supply chain in our institution.
No conflict of interest.
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