[Comparison of gemcitabine production costs in individualized and standardized doses]

Cancer chemotherapy doses are often adapted to patients' body surface area and produced individually. Alternatively, dose-banding promotes batch production of clinically defined fixed doses, for which a standard deviation of±5% determines a band incorporating individual doses calculated on the basis of body surface area. The aim is to compare the costs of individualized and batch production of gemcitabine in a centralized chemotherapy reconstitution unit.

The study was carried out using a cost-minimization analysis. The first step was to identify the percentage of gemcitabine preparations eligible for standardization over a one-year period, and to define the standardized doses of clinical interest, taking into account a standard deviation of±5%. The second step was to compare the direct and indirect costs of individualized production with those of mass production.

The percentage of standardizable preparations was evaluated at 69.8%, with standardized doses of 1500mg±5%, 1600mg±5%, 1800mg±5%, 2000mg±5% and 2200mg±5%. Comparison of production costs for a total of 324 bags over one year showed that dose-banding reduced costs by 7%.

The cost difference between individualized production and batch production of standardized doses of gemcitabine bags is in favor of dose-banding. The analysis could be extended to other anticancer molecules.