Dose rounding of chemotherapy in colorectal cancer: an analysis of clinician attitudes and the potential impact on treatment costs.
OBJECTIVE
The aims of this study were to calculate theoretical cost savings of oxaliplatin dose rounding in colorectal cancer (CRC), and to assess clinician attitudes to chemotherapy dose rounding.


METHODS
Data were obtained from a prospective data repository (BioGrid Australia) from four hospitals regarding the use of oxaliplatin, given at a standard dose of 85 mg/m(2). We examined potential cost savings for patients with a body surface area (BSA) between 1.77 m(2) and 1.94 m(2), resulting in a calculated dose up to 10% above 150 mg (a 100 mg and 50 mg vial). The attitudes of oncologists at these hospitals toward minor dose reductions were assessed.


RESULTS
From January 2003 to June 2008, of 676 patients with Stages III or IV CRC, 227 (33.58%) received oxaliplatin. Overall 66 patients (29%) had a calculated BSA between 1.77 m(2) and 1.94 m(2). The potential cost saving for these hospitals in one year, if oxaliplatin doses were rounded down to 150 mg, is $AU51,898. Extrapolated to the Australian population, estimated savings are over $AU2.5 million per year. Three of nine (33.3%) oncologists were comfortable with an initial dose reduction of up to 10% in the adjuvant disease setting, and seven of nine (77.8%) in the setting of metastatic disease.


CONCLUSIONS
Minor dose reductions for CRC to accommodate vial sizes would lead to significant cost savings. Oncologists are more comfortable with minor dose reductions when treatment is given in a palliative setting.
Field
Kathryn
K
BioGrid Australia, Parkville, Victoria, Australia. kathryn.field@mh.org.au
Zelenko
Anna
A
Kosmider
Suzanne
S
Court
Karen
K
Ng
Li-Ling
LL
Hibbert
Marienne
M
Gibbs
Peter
P
D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000191:economics*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000191:economics; D017046:Cost Savings / Q000191:economics; D017048:Health Care Costs; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008495:Medical Oncology / Q000191:economics; D009944:Organoplatinum Compounds / Q000008:administration & dosage* / Q000191:economics*; D000077150:Oxaliplatin
D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin