This is notification that the forty-second issue of the Virtual Journal Club (VJC) is available on the International Society of Oncology Pharmacy Practitioners (ISOPP) website. To access it, visit the Virtual Journal Club Surveys page or follow the direct link to the survey. 

"Potential cost savings by dose down-rounding of monoclonal antibodies in a community cancer center"
Mehmet S Copur, Curtis Gnewuch, Megan Schriner, Mark Tharnish, Mithat Gonen, Monica McDonald, Jami Kezeor, Ryan C Ramaekers, Dron Gauchan, Douglas Clark, Lois Greenwalt, Mary Mickey and Max Norvell
Journal of Oncology Pharmacy Practice (JOPP) published February 13, 2017

In the current financial climate where financial distress leads to worse mortality this is an interesting paper proposing huge cost savings by the rounding down of monoclonal antibodies to the nearest vial in the metastatic setting . It is generally felt by Haematologists and Oncologists that rounding to 5 or 10% is acceptable in this setting. The challenge is whether we are able to sustain clinical response with this intervention -further studies are required.

Learning Objectives:

1. Understanding the financial implications of monoclonal antibodies in terms of their expense, effectiveness and long term as anticancer agents;
2. Recognising that dosing with the traditional Maximally Tolerated Dose approach may be much more than is needed compared with using biologically effective dose;
3. Recognising that the majority of monoclonal anticancer agents are packaged in preservative free, single time use vials. Any amount of drug unused after opening the vial is too costly to be thrown away; and
4. Understanding that until biologically effective and fixed dose vials become a reality, dose down rounding of these agents may be an effective practical approach to reduce health care costs

Short Abstract

Monoclonal antibodies are expensive, effective, long term use anticancer agents. Their dosing based on the traditional Maximally Tolerated Dose approach may be much more than the needed biologically effective dose to control cancer. Majority of monoclonal anticancer agents are packaged in preservative free, single time use vials. Any amount of drug unused after opening the vial is too costly to be thrown away. Until biologically effective and fixed dose vials become a reality, dose down rounding of these agents may be an effective practical approach to reduce health care costs.

Accessing JOPP is easy. Log in as a member, go to the JOPP Access page and click the Access JOPP button. You have instant access.

As a reminder, ISOPP's Virtual Journal Club features online articles from the Journal of Oncology Pharmacy Practice (JOPP). Members are encouraged to read articles and then answer a series of multiple choice questions through the Virtual Journal Club Surveys. 

After completing the questionnaire, a certificate will be emailed to you. Although not formally accredited for continuing medical education (CME) points, participation is equal to one hour of CME activity.  

Members are also encouraged to use the Member Discussion Forum to stimulate discussion about articles they have read. Your ISOPP membership provides many great benefits and we are hopeful you will find the Virtual Journal Club another asset to your oncology pharmacy practice.