Dose banding and dose rounding of antineoplastic agents

Notice Santécom: 120813

The loss of antineoplastic agents is largely attributed to unusable quantities of excess agent in partially used vials and unadministered preparations that are returned and not attributed to other patients.

Dose banding aims to optimize the preparation of antineoplastic agents by reducing preparation time, minimizing wastage, and mitigating the risk of error in preparation, as well as by increasing reattribution of returned preparations. Dose rounding aims to optimize the use of vials of antineoplastic agents by reducing wastage.

INESSS was mandated to assess whether Québec’s health institutions should apply the principles of dose banding and rounding to antineoplastic agents intended for parenteral administration of adult cancer patients and, if so, to determine the terms and procedures for application and implementation.

A set of clinical and operational recommendations are presented in this notice. These recommendations should help to standardize practices pertaining to the preparation of antineoplastic agents, promote the reduction of agent wastage and optimize the treatment procedure, without compromising patient quality of life or treatment efficacy.