Analysis of non-administered chemotherapy preparations (NCPs) wastage in 2015 and 2016

Introduction

The limit value of 1% of non-administered chemotherapy preparations (NCPs) is usually mentioned as a threshold reference. The aim of this study was to rate the quantitative and economic evolution, and to analyze the different reasons for non-administration in 2015 and in 2016. Then, suggestions for improvement will emerge.

Methods

CHIMIO® software registers each chemotherapy preparation. Every NCP is prospectively collected in an EXCEL® file over these 2 years, mentioning: the drug, the dose, the cost of the preparation, the reason for non-administration.

The cost assessment of the NCPs is based on the price per milligram of drugs. The medical records and CHIMIO® software (in which the reasons of non-administration are sometimes mentioned) enable to analyze the reasons for non-administration.

Results

In 2016, 24.485 chemotherapies were prepared (namely an increase of 13.8% compared to 2015), including 288 NCPs (namely an increase of 46% compared to 2015).
The NCPs rate reported to the global activity, increased by 0.27% and represented1.17% of all the annually prepared chemotherapies in 2016.
The cost of the NCPs increased by 21% and reached 53.209 € in 2016. The number of reallocated NCPs were 3 times higher in 2016 (+ 49.5%), and contributed to mitigate financial loss by 6.299 €.
The main reasons for non-administration were similar over these 2 years: clinical or biological disorders (44 %), prescription changes after “OK Chimio” (38%).

Discussion - Conclusion

These results will be introduced to the care units with suggestions for improvement and multidisciplinary debate.
These suggestions aim to decrease the NCPs (biological disorders, absent patients, and prescription changes). A 2nd “OK Chimio”, post medical consultation, is already required for expensive drugs, and the extension of this practice will be discussed. The effectiveness of these corrective actions will be assessed by internal audits.