Pharmacists and healthcare providers are exploring dose rounding strategies as a promising approach to minimize drug waste and reduce costs while maintaining therapeutic efficacy, particularly for expensive biologic medications. This practice, when implemented within specific parameters, could lead to significant cost savings without compromising patient outcomes.
Clinical Safety and Efficacy Parameters
According to Kelsey Marques, PharmD, RPh, a PGY1 Resident at Shore Medical Center, research has demonstrated that dose rounding between 5% to 10% of the original prescribed dose can maintain clinical effectiveness without increasing adverse effects. This finding provides a scientific foundation for implementing dose rounding protocols, particularly for high-cost biologics.
"Dose rounding—if done within an acceptable range—can maintain clinical effectiveness," explains Marques. "The biggest thing would be that research had showed dose rounding between 5% to 10% of the original prescribed dose can maintain efficacy and minimize any adverse effects."
Cost Savings and Waste Reduction Factors
Multiple variables influence potential cost savings through dose rounding initiatives. Key considerations include:
- Vial sizes and packaging configurations
- Original prescribed dosages
- Drug cost per vial, particularly for high-cost biologics
- Potential waste reduction opportunities
Implementation Strategies and Challenges
The successful implementation of dose rounding protocols requires a comprehensive approach focusing on several key areas:
Interprofessional Collaboration
Pharmacists play a crucial role by:
- Analyzing drug utilization patterns
- Establishing acceptable dose rounding thresholds
- Educating healthcare providers on best practices
- Ensuring ongoing monitoring of patient safety
Overcoming Implementation Barriers
Common challenges include:
- Patient apprehension about dose modifications
- Provider education needs
- Variations in drug formulations
"The biggest challenge that really comes with this would be patient apprehension, making sure that providers are well educated as well as any difference in formulations for the drug," notes Marques.
Best Practices for Healthcare Institutions
To optimize dose rounding programs, healthcare facilities should focus on:
- Developing evidence-based institutional policies
- Providing comprehensive provider education
- Maintaining transparent communication with patients
- Establishing clear protocols for monitoring and safety
"As pharmacists, we can analyze drug utilization patterns, as well as advising unacceptable dose surrounding thresholds and ultimately educating providers on these best practices," Marques emphasizes. "We must ensure that we're maintaining patient safety and just educating patients on what we might potentially be doing if we are going to dose around."
