Rounding Down Chemotherapeutic Agents to the Nearest Vial Size as a Cost Containment Measure.
High cancer treatment costs significantly affect health care expenditures. Drug waste reduction of costly drugs can reduce the treatment cost. Methods: A retrospective study conducted at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Adult patients above age of 14 years old who received chemotherapy between March 1st to March 31st, 2015 were included. Maximum dose rounding allowed was up to 10% for palliative intent and 5% for curative intent.
A total of 305 patients received 973 doses of intravenous chemotherapy drugs during the study period. Orders of 352 doses could be rounded to the nearest vial size with a 10% dose deviation for palliative intent and 5% for curative intent.
Anti-cancer drugs with the most drug wastage due to non-rounding to the nearest vial size were trastuzumab, cyclophosphamide, etoposide, methotrexate, fluorouracil, paclitaxel, oxaliplatin, doxorubicin, bortezomib, and cytarabine consecutively. The highest costs savings when rounding the doses to the nearest vial size up to 5%.
Dose rounding of the ordered dose to an amount within 5% for curative intent and 10% for palliative intent to the nearest vial size has resulted in a valuable cost savings through reduction of drug wastage without any expected compromise in efficacy.