[Safety and costs of dose banding of high-priced drugs for cancer treatments. First Argentine experience]
- PMID: 40793885
[Safety and costs of dose banding of high-priced drugs for cancer treatments. First Argentine experience]
Abstract
Introduction: High-price drugs (HPD) represent an economic problem for the health system. Dose banding has been shown to decrease costs. The objective was to determine the economic impact and safety of HPD dose standardization.
Materials and methods: A single cohort study was conducted between May and December 2024 in 20 patients undergoing treatment (docetaxel, paclitaxel, trastuzumab, cetuximab and bevacizumab) at Churruca Visca Hospital. In the first treatment session, a standardized dose was provided and in the following 2 in a conventional way. Costs and safety were compared between the two modalities.
Variables: age, sex, diagnosis, stage, adverse events in the first 24 hours and medication prices.
Results: Eight (40%) were male, mean age 59 years. Eleven patients had a diagnosis of breast cancer (55%). Seventy-two doses were applied in sixty treatment sessions, with four minor adverse events reported. No statistically significant differences were observed between adverse events and type of drug supply. The total price of drugs was $159 362 696.46 (U$S 150 302.46). The total price if they had been provided in a conventional way was $ 164 973 946.48 (U$S 155 594.70) and if it had been done exclusively in a standardized way $ 148 350 031.39 (U$S 139 915.90) representing savings of 10%. Docetaxel and trastuzumab showed greater savings (19%).
Discussion: The use of dose banding is safe and generates significant cost savings.
Introducción: Los medicamentos de alto precio (MAP) representan una problemática económica para el sistema de salud. La estandarización de dosis (dose banding) demostró disminuir el costo. El objetivo fue determinar e impacto económico y la seguridad de la estandarización de dosis de MAP. Materiales y métodos: Estudio de cohorte única, entre mayo y diciembre de 2024 en 20 pacientes del hospital Churruca Visca en tratamiento con docetaxel, paclitaxel, trastuzumab, cetuximab y bevacizumab. En la primera sesión de tratamiento se proveyó una dosis estandarizada y en las 2 siguientes en forma convencional. Se compararon costos y seguridad entre las dos modalidades. Variables: edad, sexo, diagnóstico, estadio, eventos adversos en las primeras 24 horas y precios de la medicación. Resultados: Ocho (40%) de sexo masculino, edad promedio 59 años. Once pacientes tenían diagnóstico de cáncer de mama (55%). Se aplicaron 72 dosis en sesenta sesiones de tratamiento reportándose cuatro eventos adversos menores. No se observaron diferencias estadísticamente significativas entre eventos adversos y tipo de provisión de drogas. El precio total de la provisión fue de $ 159 362 696.46 (U$S 150 302.46). El costo total si se hubieran provisto de manera convencional hubiera sido $ 164 973 946.48 (U$S 155 594.70) y si se hubiera hecho exclusivamente en forma estandarizada $ 148 350 031.39 (U$S 139 915.90) representando un ahorro del 10%. El Docetaxel y el Trastuzumab mostraron mayor ahorro (19%). Discusión: La utilización del dose banding es segura y genera un ahorro significativo en los costos.
Keywords: chemotherapy; cost-efficiency analysis; pharmaceutical economics.
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