Minimization of olaratumab drug waste using real-world data

Am J Health Syst Pharm. 2017 Jun 1;74(11):832-842. doi: 10.2146/ajhp160254. Epub 2017 May 1.

Abstract

Purpose: Results of a study in which population-based body weight and body surface area (BSA) data were used for vial size optimization to reduce drug waste associated with administration of the i.v. anticancer agent olaratumab are reported.

Methods: A retrospective observational study was conducted to determine weight and BSA distributions in a large sample of U.S. oncology patients using data from a large electronic medical record database. Body weight and BSA values at the time of initial systemic anticancer therapy were used to compute olaratumab dose requirements in a cohort of patients with soft tissue sarcoma; those data were analyzed to derive estimates of drug waste likely to result from the use of various proposed olaratumab vial sizes in combination with an existing 500-mg size. Weight and BSA distributions were calculated for additional cohorts of patients with 7 other cancer types.

Results: Median weight values in men (n = 1,179) and women (n = 1,078) with soft tissue sarcoma were 82.55 kg (interquartile range [IQR], 72.58-95.53 kg) and 68.69 kg (IQR, 58.51-84.28 kg), respectively. Modeling of olaratumab dosing scenarios indicated that use of the 500-mg vial only would result in estimated average drug waste of 234 mg per patient per administration; analysis of various potential vial size combinations showed that waste could be reduced by 87.6% with the addition of a 190-mg vial size.

Conclusion: Analysis of real-world patient weight and BSA data allowed olaratumab vial size optimization to enable maximal dosing flexibility with minimal drug waste.

Keywords: antineoplastic agents/therapeutic use; body weight; drug packaging; drug waste; electronic health records; neoplasms/drug therapy.

MeSH terms

  • Aged
  • Antibodies, Monoclonal / administration & dosage*
  • Antibodies, Monoclonal / economics
  • Antineoplastic Agents / administration & dosage*
  • Antineoplastic Agents / economics
  • Body Surface Area
  • Body Weight
  • Cost Savings / methods
  • Drug Costs
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sarcoma / drug therapy
  • Soft Tissue Neoplasms / drug therapy

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • olaratumab