Preparation of intravenous chemotherapy bags: evaluation of a dose banding approach in an Italian oncology hospital


  • Marco Chiumente Scientific Direction, Italian Society for Clinical Pharmacy and Therapeutics, Milan - Italy
  • Alberto Russi School of Hospital Pharmacy, Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padova - Italy
  • Federica Todino Hospital Pharmacy, Azienda ULSS 4 Veneto Orientale, San Donà di Piave - Italy
  • Daniele Mengato Hospital Pharmacy, Bolzano General Hospital, Bolzano - Italy
  • Marina Coppola Hospital Pharmacy, Veneto Institute of Oncology IOV-IRCCS, Padua - Italy
  • Melania Rivano Clinical Oncology Pharmacy Department, A. Businco Hospital, Cagliari - Italy
  • Angelo Claudio Palozzo SIFaCT, Italian Society for Clinical Pharmacy and Therapeutics, Milan - Italy
  • Claudio Jommi Cergas (Centro di Ricerche sulla Gestione dell’Assistenza Sanitaria e Sociale), SDA Bocconi School of Management, Università Bocconi, Milano - Italy



Antineoplastic agent, Costs analysis, Dose banding, Drug compounding, Economic gain, Time management


Introduction: Dose banding is an original approach that manages intravenous (IV) chemotherapy preparation by generating on a weekly basis a series of bags containing scaled dosages of the active agent. These predetermined, fixed dosage bags are intended to replace the traditional bags prepared daily that contain fully individualized dosages.

Methods: Three different scenarios were examined: (1) the current method of daily preparation of individualized bags at the hospital pharmacy; (2) the weekly preparation at the hospital pharmacy of non-individualized bags containing discrete, predefined doses covering an adequate range of doses (dose banding); (3) the use of commercial ready-to-use bags based on the same approach of dose banding. The objective of this study was to compare these three different approaches in terms of cost per patient. We considered five cancer drugs (gemcitabine, oxaliplatin, paclitaxel, trastuzumab and 5-fluorouracil) that were suitable for the dose ranging approach. Appropriate dose bands for these five agents were identified. Costs were estimated for each of the three approaches.

Results: A total of 13,490 fully individualized bags were studied, which corresponded to the real bags prepared at our institution for these five agents in 2018. Dose banding was predicted to determine savings ranging from €10,998 (−0.84%) for trastuzumab to €169,429.60 (−8.39%) for paclitaxel.

Conclusion: The introduction of dose banding can determine economic savings along with other advantages, such as improved work conditions, management reorganization and containment of waste. The pharmaceutical industry can hopefully support these experiences by producing ready-to-use bags in predetermined dosages.


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How to Cite

Chiumente, M., Russi, A., Todino, F., Mengato, D., Coppola, M., Rivano, M., Palozzo, A. C., & Jommi, C. (2021). Preparation of intravenous chemotherapy bags: evaluation of a dose banding approach in an Italian oncology hospital. Global and Regional Health Technology Assessment, 8(1), 29–34.



Original Research Articles


Received 2020-11-02
Accepted 2021-03-04
Published 2021-03-26


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