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Jairia Dela Cruz, 20 Jan 2018
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Short-term treatment with methotrexate at >0.5 defined daily dose (8.75 mg/week) may help reduce the risk of ischaemic stroke in rheumatoid arthritis (RA) patients, while hydroxychloroquine and sulfasalazine have neutral effects, a retrospective study has found.
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Younger children appear to be more likely to experience behavioural side effects of antiepileptic drugs (AEDs), with the likelihood increasing if children with epilepsy have baseline hyperactivity/impulsivity, a retrospective study has found.

Dose-rounding strategy of cancer agents results in potential cost, waste avoidance

13 Feb 2018

Significant cost and waste savings can be achieved by rounding monoclonal antibodies to the nearest vial size, with minimal deviation from the actual ordered dose, a recent study suggests.

Of the 436 doses included, 237 were not rounded to the nearest vial size and thus was excluded from the analysis. Using actual wholesale price, the cost of waste related to these doses was $108,013.64. On the other hand, cost savings associated with the theoretical dose calculations were estimated at $83,595.53.

Dose rounding to the nearest vial size led to a median deviation from the ordered dose of 6.7 percent (range, 1.4‒20 percent).

In one study that involved three costly cancer agents (bevacizumab, trastuzumab and cetuximab), a 10-percent dose reduction for all cases was achieved after consultation with key physicians regarding the proposed percent reduction. Implementation of a dose-rounding policy for these three agents represents a potentially substantial cost savings. [J Oncol Pharm Pract 2015;21:280-284]

A 2011 study by Winger and colleagues found that routine dose rounding of biologic anticancer agents to an amount within 10 percent of the ordered dose resulted in cost savings through reduction of drug wastage. [J Oncol Pharm Pract 2011;17:246-251]

The current study was a single-arm, retrospective chart review evaluating all monoclonal antibody doses dispensed at an outpatient community infusion centre associated with an academic medical centre between August 2014 and August 2015.The authors reviewed all monoclonal antibody doses to determine the cost of drug wasted using two methods.

The waste-cost analysis described the amount of drug disposed of due to the use of partial vials, while the theoretical dose savings described potential cost savings based on rounding the ordered dose to the nearest vial size. To explore clinical implications, a comparison was made between the theoretical rounded dose and the actual ordered dose.

“Monoclonal antibodies possess unique pharmacokinetic properties that permit flexible dosing,” the authors said. “Increased use and high costs of these medications have led to the development of cost-containing strategies.”

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Most Read Articles
Jairia Dela Cruz, 20 Jan 2018
Empagliflozin appears to be beneficial to type 2 diabetes (T2D) patients with established cardiovascular disease (CVD) and chronic kidney disease (CKD), yielding reductions in CV and all-cause mortality, as well as in heart failure and all-cause hospitalization compared with placebo, according to a study.
13 Feb 2018
Short-term treatment with methotrexate at >0.5 defined daily dose (8.75 mg/week) may help reduce the risk of ischaemic stroke in rheumatoid arthritis (RA) patients, while hydroxychloroquine and sulfasalazine have neutral effects, a retrospective study has found.
28 Dec 2017
Varenicline, while effective for smoking cessation, appears to significantly elevate the risk of cardiovascular hospitalization and emergency department visits, particularly for new users, a recent study shows.
29 Nov 2017
Younger children appear to be more likely to experience behavioural side effects of antiepileptic drugs (AEDs), with the likelihood increasing if children with epilepsy have baseline hyperactivity/impulsivity, a retrospective study has found.