Cytotoxic Drug Wastage Resulting during the Treatment of Head and Neck Cancers: The First Study Addressing the Quantity and Economic Implications

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Abstract Background: In the treatment of head and neck cancer (HNC), because the therapeutic index is narrow and the cytotoxic drug amount to be administered needs to be accurate and varies from person to person, a substantial amount of medicine can end up as leftover. This study analyzed this aspect from a financial viewpoint. Materials and Methods: This study recorded the prescribed dose, the chemotherapy regimens employed, the quantity utilized, and the leftover waste from the nurse’s log book, whereas the cost of the drugs was noted from the pharmacy bill and the inventory. The total and average drug costs were calculated based on each person’s actual drug wastage and pharmacy bill. Results: The results of the study revealed that a total of 120 HNC patients received treatment during the study period. Cisplatin, carboplatin, docetaxel, paclitaxel, and 5-fluorouracil were utilized to treat HNC and wasted medications totaled 14850 mg and accounted for 12% of reconstituted medications. Cisplatin, carboplatin, 5-fluorouracil, paclitaxel, and docetaxel had 3.15%, 14.53%, 16.675, 9.56%, and 15.10% wastage. The drug waste cost Rs. 254,421 and docetaxel had the highest wastage cost (Rs. 119,875) and cisplatin the lowest (Rs. 6414.47). Among the combination regimens, paclitaxel–carboplatin had the largest medication wastage of 425 ± 311 and 147.5 ± 101.9 mg, respectively. Conclusion: The results of this first-of-its-kind study on drug waste in HNC treatment indicate that the unnecessary disposal of valuable anticancer medications resulted in substantial financial losses. Efforts should be made to reduce waste and save money without risking the safety of patients by altering the treatment plans or the dosing schedules.