Background The dosage of antineoplastic drugs has been historically based on body surface area or patient’s weight.
Lack of resources and increased workload at an Onco-Haematology Day Hospital (ODH) are leading to the development of new strategies to optimise the processing. One of those approaches is the dose-banding (DB) method.
Purpose Calculate Cetuximab (Cet) and Bevacizumab (Bev) doses using the DB method;
Compare initially calculated doses (ICD) with those obtained through DB and assess the economic impact.
Material and methods All ODH patients with ≥18 years, Cet prescription from November 2017 to August 2018 or Bev from January 2018 to August 2018 were included. Patients with <45 kg or >100 kg were excluded.
The ICDs were initially calculated according to the summary of product characteristics. Then, using National Health Service England DB tables, ICDs were adjusted to a dose obtained by DB (DDB). The range recommended for dose adjustments is 5%–10%.
ICDs and DDBs were recorded.
Using the average price of the drug in our hospital, expenditures made with and without DB were calculated.
Results Doses for 150 preparations of Cet and 406 preparations of Bev were calculated.
For Cet, the DDB were 2.8% lower than ICD, so less drug was used, which represents savings of €/16,409/year.
Regarding Bev, the DDB were 3.1% lower than ICD, which generates savings of €/63,343/year.
Conclusion We found that the introduction of DB to have a noteworthy impact on oncology service total expenditures.
Dose adjustments made were within the recommended range. The method has been used in Europe which has studies that support its applicability.
In our ODH there is a policy of using one vial for more than one patient, so the estimated savings may be slightly lower.
Additionally, DB adds another factor of variability to the final dose that will be administered to the patient.
The DB promotes rational drug use.
This may be a future approach to other drugs in onco-haematology.
References and/or acknowledgements Baker JP, et al. University Hospital Birmingham National Health Science Trust. J Oncol Pharm Pract 1998;4:10–4.
Williamson S. Guidelines for dose banding cancer chemotherapy 2013:1–15.
No conflict of interest.
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