Cost Savings and Waste Reduction Through Redispensing Unused Oral Anticancer Drugs

Author:

Smale Elisabeth M.1,van den Bemt Bart J. F.12,Heerdink Eibert R.345,Desar Ingrid M. E.6,Egberts Toine C. G.34,Bekker Charlotte L.1,de Bruin Anneloes7,van Vlijmen Bas7,Burger Desirée7,Balk Thijs7,

Affiliation:

1. Department of Pharmacy, Radboud University Medical Center, Nijmegen, the Netherlands

2. Department of Pharmacy, Sint Maartenskliniek, Ubbergen, the Netherlands

3. Department of Clinical Pharmacy, Division of Laboratory, Genetics and Pharmacy, University Medical Centre Utrecht, Utrecht, the Netherlands

4. Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Faculty of Science, Utrecht, the Netherlands

5. Research Group Innovations of Pharmaceutical Care, Utrecht University of Applied Medical Centre Utrecht, Utrecht, the Netherlands

6. Department of Medical Oncology, Radboud University Medical Center, Nijmegen, the Netherlands

7. for the ROAD Study Group

Abstract

ImportanceNew strategies targeting waste are required to improve financial and ecologic sustainability of expensive therapies, such as oral anticancer drugs, that frequently remain unused by patients. Redispensing unused oral anticancer drugs seems to be a promising strategy when drug quality is guaranteed.ObjectivesTo determine the waste reduction and net cost savings attained by redispensing oral anticancer drugs that go unused by patients compared with the standard practice of disposal.Design, Settings, and ParticipantsThe ROAD study was a prospective single-group intervention conducted in the outpatient pharmacies of 4 hospitals in the Netherlands from February 1, 2021, to February 1, 2023, with 12-month follow-up of each patient. Patients with cancer and who had a prescription for an oral anticancer drug that could be stored at room temperature were included. Of 2426 eligible patients, 602 did not consent and 601 did not respond. Data analyses were performed from August 25, 2022, to April 19, 2023.InterventionParticipants received oral anticancer drugs for use at home in special packaging (ie, sealed packaging with time-temperature indicator), to be returned to the pharmacy should these remain unused. The pharmacy ensured quality of returned drugs based on authenticity, appearance, remaining shelf life and adequate storage temperature. Drugs fulfilling quality requirements were redispensed to other patients.Main Outcome and MeasureTotal waste reduction and mean net annual cost savings per patient compared with the standard practice of disposal. Optimization of cost savings was explored by introducing variations in the quality assurance procedure and patient population. All analyses used the average exchange rate for 2021 €1 = US $1.18.ResultsOf 1223 patients with cancer who consented, 1071 participated (median [IQR] age, 70 [62-75] years; 622 [58.1%] were male). In all, 171 patients (16.0%; 95% CI, 13.8%-18.3%) returned 335 unused oral anticancer drug packages. Of the returned drugs, 228 packages were redispensed, which reduced waste by 68.1% (95% CI, 67.7%-68.5%) compared with the standard practice (disposal). Redispensing unused oral anticancer drugs comprised 2.4% (95% CI, 2.2%-2.5%) of total drug costs, providing mean net annual cost savings of US $680 (95% CI, $524-$837) up to $1591 (95% CI, $1226-$2002) per participant.Conclusions and RelevanceThe findings of this multicenter intervention study indicate that redispensing unused oral anticancer drugs is associated with waste reduction and cost savings, which in turn may improve the affordability and sustainability of cancer treatment.Trial RegistrationWorld Health Organization International Clinical Trials Registry Platform Identifier: NL9208

Publisher

American Medical Association (AMA)

Subject

Oncology,Cancer Research

Cited by 7 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3