Advertisement

Exploratory analysis for the implementation of antineoplastic logarithmic dose banding

  • A. Albert-Marí
  • S. Valero-García
  • V. Fornés-Ferrer
  • J. L. Poveda-Andrés
Research Article

Abstract

Background Dose banding (DB) is a strategy to rationalise antineoplastic production at Hospital Pharmacy Aseptic Compounding Units (ACUs) and to reduce patient’s waiting time. DB allows for optimizing workflows and workloads, facilitating adoption of new technologies, and increasing safety, quality and efficiency of the compounding process. Objective To evaluate the potential impact of implementation of Logarithmic DB and to identify antineoplastic agents and preparations that fulfil criteria published and establish the number and standard doses that could be compounded in advance at the ACU. Setting University and Polytechnic third level general hospital. Method Retrospective observational study (December 2015–May 2016). Antineoplastic dose production was analysed. Investigational drugs were excluded. Three criteria were applied following bibliography reviewed to select candidates to be compounded at our ACU as standardised using logarithmic DB: (a) Antineoplastic preparations > 250 per year; (b) psychochemical stability in optimal storage conditions at least 14 days; (c) maximum five logarithmic standardised doses that include at least 60% of all individualised doses compounded for a given drug. Main outcome measure Number of antineoplastic agents, preparations and logarithmic standard doses candidates to DB. Results 15,436 antineoplastic individualised doses corresponding to 69 antineoplastic agents were analysed. At our institution applying selection criteria, 19 (27%) antineoplastic drugs (3 monoclonal antibodies, 16 cytotoxic) were potential candidates to DB. 6285 (40%) of compounded individualised dose preparations could be prepared in 84 logarithmic standard doses in advance. Conclusion Dose banding implementations could contribute to rationalise antineoplastic production and increase the ACUs compounding capacity.

Keywords

Antineoplastic agents Dose banding Drug compounding Quality improvement Standard preparations 

Notes

Acknowledgements

We like to thank Arash Javadinejad for his assistance in the revision.

Funding

None.

Conflicts of interest

The authors declare no conflicts of interests.

References

  1. 1.
    National Cancer Control Programme (NCCP) Working Group. Dose banding for systemic anticancer therapy (SACT) Guidance document. [Internet]. Version 1. [Dublin]: Ireland´s Health Service. 2016 Jun [cited 2018 Mar 23]. http://www.hse.ie/eng/services/list/5/cancer/profinfo/medonc/NCCP%20Dose%20Banding%20Guidance%20Document.pdf.
  2. 2.
    Plumridge RJ, Sewell GJ. Dose-banding of cytotoxic drugs: a new concept in cancer chemotherapy. Am J Health Syst Pharm. 2001;58:1760–4.PubMedGoogle Scholar
  3. 3.
    Northern England Strategic Clinical Network. Guidelines for the dose banding of cancer chemotherapy. [Internet]. Version 2. Newcastle Upon Tyne: National Health System England. 2015 Nov. [cited 2018 Mar 23]. http://www.nescn.nhs.uk/wp-content/uploads/2016/01/NECN-dose-banding-guidelines-version-2.0-Nov-151.pdf.
  4. 4.
    Faure S, Noirez V. Préparations hospitalières de médicaments anticancéreux à doses standardisées ou “dose-banding”. Tech Hosp Med Soc Sanit. 2010;719:27–34 (French).Google Scholar
  5. 5.
    Soumoy L, Pirlot C, Decoster C, Gillet P, Hecq JD. Etude préliminaire pour l’ implémentation d’ un dose-banding de chimiothérapie anticancéreuse. J Pharm Belg. 2015;3:24–35 (French).Google Scholar
  6. 6.
    Gilbar PJ, Chambers CR, Gilbar EC. Opportunities to significantly reduce expenditure associated with cancer drugs. Future Oncol. 2017;13:1311–22.CrossRefPubMedGoogle Scholar
  7. 7.
    Mayor S. National Health Service England introduces dose banding. Lancet Oncol. 2016;17(7):e271.  https://doi.org/10.1016/S1470-2045(16)30199-1.CrossRefPubMedGoogle Scholar
  8. 8.
    Iwamoto T, Morikawa T, Hioki M, Sudo H, Paolucci D, Okuda M. Performance evaluation of the compounding robot, APOTECAchemo, for injectable anticancer drugs in a Japanese hospital. J Pharm Health Care Sci. 2017;24(3):12.  https://doi.org/10.1186/s40780-017-0081-z.CrossRefGoogle Scholar
  9. 9.
    Seger AC, Churchill WW, Keohane CA, Belisle CD, Wong ST, Sylvester KW, et al. Impact of robotic antineoplastic preparation on safety, workflow, and costs. J Oncol Pract. 2012;8:344–9.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Kaestner SA, Sewell GJ. A national survey of UK prescribers’ opinions on chemotherapy dosing and dose-banding. Clin Oncol (R Coll Radiol). 2009;21:320–8.CrossRefGoogle Scholar
  11. 11.
    Royo-Peiró MA, Moya-Gil A, Porta-Oltra B, Albert-Marí A, Maestu-Maiques I, Climente-Martí M. Opinión de los oncólogos médicos sobre estandarización de dosis de antineoplásicos. In: Poster presented at: 4th Congreso de Oncología Médica y Farmacia Oncológica; 2016 Nov 24-26; Toledo, Spain. [cited 2018 Mar 23]. http://www.tendiendopuentes.es/wp-content/themes/meeton/pdf/posters/67.pdf.
  12. 12.
    Chatelut E, White-Koning M, Mathijssen R, Puisset F, Baker S, Sparreboom A. Dose banding as an alternative to body surface area-based dosing of chemotherapeutic agents. Br J Cancer. 2012;107:1100–6.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Kaestner S, Walker V, Perren T, Sewell GJ. Pharmacokinetic assessment of dose-banded chemotherapy [abstract]. Pharmacotherapy. 2005;25:1545.Google Scholar
  14. 14.
    White-Koning M, Osborne C, Paci A, Boddy AV, Chatelut E, Veal GJ. Investigating the potential impact of dose banding for systemic anti-cancer therapy in the paediatric setting based on pharmacokinetic evidence. Eur J Cancer. 2018;91:56–67.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Mathijssen RH, De Jong FA, Loos WJ, Van der Bol JM, Verweij J, Sparreboom A. Flat-fixed dosing versus body surface area based dosing of anticancer drugs in adults: does it make a difference? Oncologist. 2007;12:913–23.CrossRefPubMedGoogle Scholar
  16. 16.
    Fahrenbruch R, Kintzel P, Bott AM, Gilmore S, Markham R. Dose rounding of biologic and cytotoxic anticancer agents: A Position Statement of the Hematology/Oncology Pharmacy Association. J Oncol Pract. 2018;14(3):e130–6.  https://doi.org/10.1200/JOP.2017.025411.CrossRefPubMedGoogle Scholar
  17. 17.
    National Dose Banding Table drug list. [Internet]. Version 7. [London]: National Health Service England. 2018 Jan [cited 2018 Mar 23]. https://www.england.nhs.uk/wp-content/uploads/2018/01/national-dose-banding-table-drug-list-v7.pdf.
  18. 18.
    Claus B, De Pourcq K, Clottens N, Kruse V, Gemmel P, Vandenbroucke J. The impact of logarithmic dose banding of anticancer drugs on pharmacy compounding efficiency at Ghent University Hospital. Eur J Hosp Pharm. 2017.  https://doi.org/10.1136/ejhpharm-2016-001093.Google Scholar
  19. 19.
    Vigneron J, Astier A, Trittler R, Hecq JD, Daouphars M, Larsson I, et al. French Society of Hospital Pharmacists; European Society of Oncology Pharmacists. SFPO and ESOP recommendations for the practical stability of anticancer drugs: an update. Ann Pharm Fr. 2013;71:376–89.CrossRefPubMedGoogle Scholar
  20. 20.
    Gillian A. BOPA Toolkit: how to implement dose banding of chemotherapy. Network pharmacist (NELCN) on behalf of cancer network pharmacists [Internet]. Version 1. [London]: British Oncology Pharmacy Association (BOPA). 2008. [cited 2017 May 25]. http://www.bopadev.co.uk/contentimages/publications/Toolkit_Ver_3.0_FINAL.pdf.
  21. 21.
    Zavery B, Marsh G. Could logarithmic dosing change the way cytotoxics are prescribed? Clin Pharm. 2011;3:116–8.Google Scholar
  22. 22.
    Vigneron J, Gindre I, Daouphars M, Lider P, Gardier S, editors. Dose-banding: a way to rationalize the production of chemotherapy: results of the stabilis survey [Internet]. Infostab Newsl. 2014 Dec [cited 2018 Mar 23];(27):3. http://www.stabilis.org/sourcesPDF/Fichier.10868.3.pdf.
  23. 23.
    Pouliquen AL, Escalup L, Jourdan N, Cottu P, Faure P, Madelaine-Chambrin I. Dose standardisation of anticancer drugs. Int J Clin Pharm. 2011;33:221–8.CrossRefPubMedGoogle Scholar
  24. 24.
    Fonts Serra N, Mullera Martí M, Cardenete Ornaque J, Cardona Pera D, Mangues Bafalluy MA. Guía de Estabilidad y Condiciones de Administración de Citostáticos, Anticuerpos Monoclonales y otros Medicamentos. Barcelona: EDIMSA; 2015.Google Scholar
  25. 25.
    Oswald K. Chemotherapy dose banding to be rolled out across England. Pharm J [Internet]. 2016 Jun 1 [cited 2018 Mar 23]; 296(7890). https://www.pharmaceutical-journal.com/news-and-analysis/news/chemotherapy-dose-banding-to-be-rolled-out-across-england/20201231.article,  https://doi.org/10.1211/pj.2016.20201231.
  26. 26.
    Guía de buenas prácticas de preparación de medicamentos en servicios de farmacia hospitalaria. [Internet]. Madrid: Ministerio de Sanidad, Servicios Sociales e Igualdad; 2014 Jun. [cited 2018 Mar 23]. https://www.msssi.gob.es/profesionales/farmacia/pdf/GuiaBPP3.pdf. (Spanish).
  27. 27.
    Sánchez-Rubio Ferrández J, Rodríguez Vargas B, Sánchez-Rubio Ferrández L, Lozano Estevan MC, Iglesias Peinado I. CSTDs and microbiological stability of cytostatics. Hosp Pharm Eur [Internet]. Oct-Nov 2013 [cited 2018 Mar 23]; (70). http://www.hospitalpharmacyeurope.com/closed-system-devices/cstds-and-microbiological-stability-cytostatics.
  28. 28.
    Cortell-Fuster C, Martínez-Benavides J, Moya-Gil A, Pavía-Calvo H, Llopis-Salvia P, Climente-Martí M. Dose banding de levofolinato cálcico en cáncer colorrectal metastásico [abstract]. Farm Hosp. 2016;40(Suppl 1):S461–2 (Spanish).Google Scholar
  29. 29.
    Nuttall R, Clark J, Polwart C, Marsh G. Dose banding: a pragmactic approach. Hosp Pharm Eur [Internet]. 2016 Spring [cited 2018 Mar 23]; (81). http://www.hospitalpharmacyeurope.com/oncology/dose-banding-pragmatic-approach.
  30. 30.
    Scottish Cancer Pharmacy Group. Guidelines for dose banding of systemic anticancer therapy guidelines. Edimburgh: Scottish Cancer Pharmacy Group; 2012.Google Scholar
  31. 31.
    Reinhardt H, Trittler R, Eggleton AG, Wöhrl S, Epting T, Buck M, et al. Paving the way for dose banding of chemotherapy: an analytical approach. J Natl Compr Cancer Netw. 2017;15:484–93.CrossRefGoogle Scholar
  32. 32.
    Ogungbenro K, Patel A, Duncombe R, Nuttall R, Clark J, Lorigan P. Dose rationalization of pembrolizumab and nivolumab using pharmacokinetic modeling and simulation and cost analysis. Clin Pharmacol Ther. 2018;103:582–90.CrossRefPubMedGoogle Scholar
  33. 33.
    Lovett D. Automation of a dose banded bortezomib campaign dispensing system. In: Short oral communication presented at: 14th Group of Evaluation and Research for Protection in Areas under Control (GERPAC) conference; 2016 Oct 5–7; Presqu’île de Giens—Hyères, France. [cited 2018 Mar 23]. http://www.gerpac.eu/automation-of-a-dose-banded-bortezomib-campaign-dispensing-system-1337.
  34. 34.
    International Society of Oncology Pharmacy Practicioners Standards Committee. ISOPP standards of practice. Safe handling of cytotoxics. J Oncol Pharm Pract. 2007;13(Suppl):1–81.Google Scholar
  35. 35.
    McKavanagh D. Is the chemo ready yet?! Gaining efficiency in parenteral cancer chemotherapy supply at a large tertiary level hospital. In: Poster presented at: 40th Clinical Oncology Society of Australia (COSA) annual scientific meeting; 2013 Nov 12–14; Adelaide, Australia. [cited 2018 Mar 23]. http://cosa2013.m.asnevents.com.au/schedule/session/2505/abstract/9337.
  36. 36.
    Kaestner S, Sewell GJ. Pharmacoeconomic aspects of dose-banding. Hosp Pharm Eur [Internet]. May-Jun 2006 [cited 2018 Mar 23]. (26). http://www.hospitalpharmacyeurope.com/featured-articles/pharmacoeconomic-aspects-dose-banding.
  37. 37.
    Sewell GJ. The clinical impact of dose-banding. In: Paper presented at: 9th Group of Evaluation and Research for Protection in Areas under Control (GERPAC) conference; 2006 Oct 4–6; Giens Peninsula, France. [cited 2018 Mar 23]. https://www.gerpac.eu/the-clinical-impact-of-dose-banding.
  38. 38.
    O’Leary CE, Collins A, Henman MC, King F. Introduction of a dose-banding system for parenteral chemotherapy on a haematology-oncology day ward. J Oncol Pharm Pract. 2017.  https://doi.org/10.1177/1078155217736376.PubMedGoogle Scholar
  39. 39.
    De Lemos M, editor. Dose banding of infusional fluorouracil. Systemic Ther Update [Internet]. 2014 Oct 1 [cited 2018 Mar 23];17(10):2. http://www.bccancer.bc.ca/systemic-therapy-site/Documents/STUpdateOct2014_1Oct2014_rev.pdf.
  40. 40.
    Pérez Huertas P, Cueto Sola M, Escobar Cava P, Borrell García C, Albert-Marí A, López Briz E, et al. Applying dose banding to the production of antineoplastic drugs: a narrative review of the literature. Farm Hosp. 2015;39:210–6.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Pharmacy Department, Área del MedicamentoHospital Universitario y Politécnico La FeValenciaSpain
  2. 2.Plataforma de Data Science, Bioestadística y BioinformáticaIISLaFeValenciaSpain

Personalised recommendations