Safety and quality assurance of chemotherapeutic preparations in a hospital production unit: acceptance sampling plan and economic impact

J Oncol Pharm Pract. 2012 Jun;18(2):163-70. doi: 10.1177/1078155211402865. Epub 2011 May 10.

Abstract

Objective: The opportunity to apply a sampling plan was evaluated. Costs were computed by a microcosting study.

Setting: In 2003, a sampling plan was defined to reduce the number of chemotherapy quality controls while preserving the same level of quality. Recent qualitative and quantitative changes led us to define a second sampling plan supplemented by an economic evaluation to determine the cost and cost-savings of quality control.

Methods: The study considers preparation produced during four semesters classified into three groups. The first one includes drugs produced below 200 batches a semester. Group 2, those for which the lot of preparation lots would have been rejected twice among these four semesters. Group 3, those would have been accepted (≥3 'acceptable lot'). A single sampling plan by attributes was applied to this group with an acceptance quality level of 1.65% and a lot tolerance percent defective below 5%. A micro-costing study was conducted on quality control, from the sampling to the validation of the results.

Results: Among 39 cytotoxic drugs, 11 were sampled which enabled to avoid a mean of 17,512 control assays per year. Each batch of the 28 non-sampled drugs was however analyzed. Costs were estimated at 2.98€ and 5.25€ for control assays depending of the analytical method. The savings from the application of the sampling plans was 153,207€ in 6 years.

Conclusion: The sampling plan allowed maintaining constancy in number of controls and the level of quality with significant costsavings, despite a substantial increase in drugs to assay and in the number of preparations produced.

MeSH terms

  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / economics*
  • Antineoplastic Agents / standards*
  • Drug-Related Side Effects and Adverse Reactions / economics
  • Pharmacy Service, Hospital / economics*
  • Pharmacy Service, Hospital / methods
  • Pharmacy Service, Hospital / standards*
  • Quality Assurance, Health Care / economics*
  • Quality Assurance, Health Care / methods
  • Quality Assurance, Health Care / standards*
  • Sampling Studies

Substances

  • Antineoplastic Agents