Evaluating cost savings in cytotoxic leftover management: A prospective study of vial sharing and dose rounding techniques in the Moroccan National Institute of Oncology.

Objective: Most intravenous anticancer drugs are administered in a dose per unit area or body weight, if not promptly administered to another patient cytotoxic leftover would be destroyed. To contain wastage, low-cost measures are highly desirable to contain and reduce expenditures without impairing the quality of care. The objective of the study is to evaluate the cost saved through the use of the two cytotoxic waste management techniques implemented in National Institute of Oncology's centralized chemotherapy preparation unit, vial sharing and dose rounding.

Method: A 6-month prospective single centre study from 1 February to 1 August 2023 at the National Institute of Oncology of Rabat in Morocco. The number of prepared preparations and amount of drug saved by both vial sharing and dose rounding was collected using the centralized chemotherapy preparation unit's 'leftover tracking file', the corresponding cost saved were calculated and then compared for each technique and with 2018 results.

Results: In total, 18,218 preparations were considered in the 6-month study. With the vial sharing technique 636,524.5 mg were saved corresponding to 246,031.4 (USD) saved cost, against 212,838.4 mg by dose rounding corresponding to 75,598.5 (USD) saved cost. This saving corresponded to a total of 321,629.4 (USD). Compared to the 2018 results leftovers costs saved by vial sharing corresponded to 289,972.05 (USD) by vial sharing technique for 1-year extrapolated period, and this study shows a saved cost of 321,629.9 (USD) by both vial sharing and dose rounding techniques.

Conclusion: Dose rounding technique combined with vial sharing allowed National Institute of Oncology's centralized chemotherapy preparation unit to limit expensive cytotoxic cost wastage, highlighting these technique benefits.