Quantification of Chemotherapy Drug Wastage and Incurred Financial Loss in Paediatric Cancer Care: A Cross-Sectional Study at a Tertiary Care Public Hospital in India.

AIM: The evolving chemotherapy landscape continually introduces effective agents, but escalating costs call for an evaluation of drug wastage and financial consequences to enhance resource utilization. This study seeks to estimate chemotherapy drug wastage and its economic loss in paediatric cancer care.

METHODS: In this cross-sectional study of paediatric cancer patients receiving parenteral chemotherapy, we evaluated both the drug used and wasted during each administration. The monetary value of drug loss was calculated using the formula: Cost = Proportion of drug wasted X Cost of drug vial.

RESULT: A total of 100 paediatric cancer patients who received 140 parenteral drug administrations of 22 chemotherapy drugs were studied. The total amount of drug procured was 25,515 mg, out of which 5,004.9 mg were wasted. Wastage amounted to 19.61% of the procured drugs in varying proportions. The total estimated cost of chemotherapy stood at 110,143.1 INR (1,328.7 USD), with cost wastage accounting for 31,929.95 INR (385.19 USD), equivalent to 28.98% of the total expenditure. Notably, doxorubicin 112.2 mg (37.4%) exhibited the highest drug wastage, followed by cytarabine 280 mg (35%) and l-asparaginase 83,400 IU (26.9%), primarily prescribed for acute lymphocytic leukaemia. Cytarabine resulted in the highest financial loss. Dose rounding occurred in 22 cases (15.71%), while vial sharing was observed in only five cases (3.57%) during drug administrations. Methotrexate, doxorubicin, and cytarabine doses never matched the available vial sizes.

CONCLUSIONS: In resource-limited healthcare settings, implementing centre-specific measures, such as vial sharing and drug categorization, can reduce drug wastage and financial losses. Evaluating the viability of optimizing vial sizes and producing multidose vials is essential.