Minder kosten voor antikankermiddelen door veiligheidsmarge rond de berekende dosis en door afstemming op ampulsterktes

Objective

To determine if the rational application of dose individualization of anticancer drugs leads to a reduction in costs.

Design

Data analysis.

Method

At the Ikazia Hospital in Rotterdam, the Netherlands, over the first 19 weeks of 2006 the costs of the intravenous administration to patients of one or more anticancer drugs were determined. The costs of dosage based on body surface area (BSA) were calculated. Commercially available ampoule strengths were not taken into consideration. Using available pharmacokinetic data, it is reasonable to assume that a deviation of up to 10% based on an individualized dose calculated by body surface area, has a negligible effect on the outcome of treatment. For this reason drug costs by rounding off doses to whole ampoules were also investigated. A condition of this was that the rounded-off dose should not deviate by more than 10% from the dose calculated on body surface area.

Results

During the study period, 18 different anticancer drugs were administered a total of 939 times. If dosage had been based strictly on body surface area, drug costs would have been €509,664. Rounding off to whole ampoules with a dose margin of a maximum of 10% would have cost € 465,619: a reduction in cost of 8.6%.

Conclusion

The rational application of the dose individualization principle based on body surface area may result in a substantial reduction in expenditure on anticancer drugs.