Affiliation:
1. Department of Pharmacy, Mayo Clinic, Phoenix, AZ, USA
2. Department of Pharmacy, Moffitt Cancer Center, Tampa, FL, USA
3. Department of Pharmacy, Mayo Clinic, Rochester, MN, USA
Abstract
Abstract
Purpose
To decrease drug waste and cost by implementing automated chemotherapy dose rounding rules in the electronic health record (EHR). Dose rounding of chemotherapy is a recognized method for reducing drug waste, and professional organizations have published guidelines recommending dose rounding when possible.
Summary
On the basis of current literature and guideline recommendations, Mayo Clinic developed system-wide consensus to allow dose rounding for biologic and chemotherapy agents to the nearest vial size if rounding resulted in the dose being within 10% of the originally calculated dose or to a convenient measurable volume, based on concentration of the drug, if rounding to the nearest vial size resulted in the dose being outside the 10% range. Oncology pharmacists reviewed and analyzed all drugs listed in the EHR used in injectable form for the treatment of cancer and developed dose rounding rules. The rules were implemented and applied at the dose calculation stage before provider signature. From January to June 2019, approximately 40,000 cancer treatment doses were administered. The rounding rules saved a total of 9,814 vials of drug, of which 5,329 were for biologic agents and 4,485 were for oncolytic drugs. This resulted in a total 6-month cost savings of $7,284,796 (in 2019 dollars; biologics, $5,727,402; oncolytics, $1,557,394).
Conclusion
Systematic implementation of dose rounding rules utilizing the EHR can result in significant reduction of drug waste and realization of savings.
Publisher
Oxford University Press (OUP)
Subject
Health Policy,Pharmacology
Reference16 articles.
1. Global initiative to establish and implement dose rounding policy for expensive cancer therapy;Ibrahim;J Pharm Care Health Syst.,2018
2. Spending on antineoplastic agents in the United States, 2011 to 2016;Hong;J Oncol Pract.,2018
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