Background and Importance Luspatercept is an erythroid maturation agent, indicated for myelodysplastic syndrome and β-thalassaemia, reimbursed by the Italian National Health Service as of 09/12/2021. Luspatercept binds to ligands of the transforming growth factor β family by blocking the Smad2/3 signalling pathway that induces maturation of late erythroid precursors. Patients receive luspatercept every 3 weeks at a per-kilo dose (three steps of incremental doses in myelodysplastic syndromes, and two steps in b-thalassemia). A drug day was set up together with the clinicians.

Aim and Objectives The objective of this study was to assess whether the establishment of drug day could lead to significant savings for the preparation of luspatercept in 2022.

Material and Methods All prescriptions and preparations made at our Unit from 1 January to 31 December 2022 were analysed by means of data extraction from the internal management system for onco-haematologic therapies. The milligrams and vials that hypothetically should have been used were calculated and valued with those actually used.

Results In 2022, 21 patients were treated for a total of 155 treatments (average of 7.38 doses per patient). A total of 16,658 mg of luspatercept was prescribed. 177 bottles of 75 mg and 61 bottles of 25 mg were used for a total of 14,800 mg. The difference of 1,858 mg between hypothetical and actual data shows the presence of an overfill of average powder equal to 3,139 mg for the packaging of 25 mg and 9,417 mg for the packaging of 75 mg (12,56% of nominal filling). The VAT costs included for the individual bottles were: 2421,02€ for the 75 mg bottle and 807,01€ for the 25 mg bottle (exactly 1/3 of the higher dosage). The total expenditure incurred was € 477,748.15 against the hypothetical expenditure of €538,275.61, with a net saving of € 60,527.52 (11.24% of the theoretical expenditure).

Conclusion and Relevance The administration of luspatarcept organised in drug day has led to a saving due to better management of waste and overfill. These results show how well-established pharmaceutical management and management strategies in clinical practice such as the drug day turn out to be an excellent method of minimising processing residues and controlling expenditure.

Conflict of Interest No conflict of interest.