Anticancer drugs preparation in the hospital : proposition of tools to help the implementation of dose banding
Anticipating production of anticancer drugs by preparing standard dose (SD) batches, also called dose banding (DB), seems to be an interesting solution in response to the increase of compounding activity.
After selecting the most relevant molecules based on proportion volume, stability and cost criteria, a retrospective study on the prescriptions of anticancer drugs should be conducted to define the SD, calculate their consumption and estimate the volume and the production frequency of batches. To facilitate the processing of extracted data, four Excel® files have been created.
When a new anticancer drug is selected for use, the first tool ADoC (“Analyse des Doses de Chimiotherapie”) calculates the frequency at which each dosage is prescribed, helps to identify SD along with their dose ranges and estimates the percentage of prescriptions covered by a defined SD.
The second tool ADoST (“Analyse des Doses Standardisées) enables the assessment of the mean daily consumption and regularity of prescription of each SD.
Once the consumption and the stability are known, the third tool DETAL (“Determination de la taille des lots”) can estimate the number of units per production batch and their frequency.
Finally the tool OSS (“Outil de Simulation des Stocks”) helps to confirm that the parameters defined previously are relevant for each SD. By considering the number of units per batch, stability and true consumption, a chart shows stock-outs, units which expired and allows us to adjust the batches production.
These four Excel tools can be used by each team using Chimio® software. By complementing each other they quickly analyze the extracted data and give relevant parameters for the implementation of DB. A critical examination of the results allows each team to a customized implementation of this new activity.