[Dose banding. Observational study on cost optimization in chemotherapy].

Abstract

Introduction: The cost of cancer treatments is a concern of the health system. The search for strategies that optimize the costs of these treatments is essential to ensure access to them. Dose banding is a methodology that has been successfully implemented in several countries, demonstrating effectiveness and efficiency. It is based on establishing dose bands rounding cytostatics ±5% and monoclonal antibodies ±10%, optimizing commercial presentations and avoiding waste. In our country there are no experiences with this system. The objective was to evaluate the savings in drug costs using dose banding.

Material and methods: Observational study of the costs of oncology drugs in a sample of patients affiliated with the Institute of Social Work of the Armed Forces (IOSFA) diagnosed with breast, colon and prostate cancer who received treatment during June 2022. The cost of each dose was determined and was simulated according to the dose banding system.

Results: Twenty-eight patients who received 29 doses were analysed.

Diagnoses: colon cancer (n:7; 25.0%), breast cancer (n:18; 64.3%) and prostate cancer (n:3; 10.7%). Mean age 61.7 years (range 34-85 years); 22 patients were female. Drugs tested: bevacizumab, cabazitaxel, cetuximab, docetaxel, trastuzumab, and trastuzumab+emtasine. The total cost was $14 101 596.39 (U$S 112 605.58 -sale value of the U.S. dollar in the Banco Nación Argentina, June 30, 2022), the simulation of the application of dose banding showed a cost of $11 185 371.49 (U$S 89 318.63). The potential savings are 20.7%.

Discussion: Dose standardization may represent a strategy that generates a significant decrease in cancer treatment costs.