Drug waste minimization as an effective strategy of cost-containment in Oncology

Gianpiero Fasola,Giuseppe Aprile,Luisa Marini,Alessandro Follador,Manuela Miscoria,Mauro Mansutti

doi:10.1186/1472-6963-14-57

Gianpiero Fasola, Giuseppe Aprile + Show 4 more

Open Access

https://doi.org/10.1186/1472-6963-14-57

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Abstract

BackgroundSustainability of cancer care is a crucial issue for health care systems worldwide, even more during a time of economic recession. Low-cost measures are highly desirable to contain and reduce expenditures without impairing the quality of care. In this paper we aim to demonstrate the efficacy of drug waste minimization in reducing drug-related costs and its importance as a structural measure in health care management.MethodsWe first recorded intravenous cancer drugs prescription and amount of drug waste at the Oncology Department of Udine, Italy. Than we developed and applied a protocol for drug waste minimization based on per-pathology/per-drug scheduling of chemotherapies and pre-planned rounding of dosages.ResultsBefore the protocol, drug wastage accounted for 8,3% of the Department annual drug expenditure. Over 70% of these costs were attributable to six drugs (cetuximab, docetaxel, gemcitabine, oxaliplatin, pemetrexed and trastuzumab) that we named ‘hot drugs’. Since the protocol introduction, we observed a 45% reduction in the drug waste expenditure. This benefit was confirmed in the following years and drug waste minimazion was able to limit the impact of new pricely drugs on the Department expenditures.ConclusionsFacing current budgetary constraints, the application of a drug waste minimization model is effective in drug cost containment and may produce durable benefits.

Highlights

Sustainability of cancer care is a crucial issue for health care systems worldwide, even more during a time of economic recession
The ASCO statement on the spiralling costs of cancer care suggest that the multiple factors lying beneath the rising expenditures in Oncology are a consequence of insufficient integration and coordination in health care systems [3]
We present the results of the cost-containment policy study split into years

Summary

Introduction

Sustainability of cancer care is a crucial issue for health care systems worldwide, even more during a time of economic recession. Low-cost measures are highly desirable to contain and reduce expenditures without impairing the quality of care. The burden of cancer is increasing, producing skyrocketing costs which have a significant impact on health care expenditure in all developed countries. The ASCO statement on the spiralling costs of cancer care suggest that the multiple factors lying beneath the rising expenditures in Oncology are a consequence of insufficient integration and coordination in health care systems [3]. Prescription drug expenditure is only a small percentage of health care costs [6], antineoplastics alone represent a significant and growing part of this spending (~15% [5]) and are the leading category in hospital drugs expenses [7]. Even though few data are available, drugrelated expenditure is proportionally higher in Oncology than in other medical specialities and overcome staffing costs for outpatients care [8,9]

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