Dr Scott Soefje Dives Into Results of Mayo Clinic's Dose Rounding Project


Scott Soefje, PharmD, director of pharmacy cancer care at Mayo Clinic, explains the various ways drug dose rounding can reduce waste, reduce costs, and make drug administration more efficient.

At AMCP 2023, Scott Soefje, PharmD, director of pharmacy cancer care at Mayo Clinic, explains how rounding vial sizes up or down can save medical centers millions of dollars annually, reducing drug costs and drug waste.


Can you describe the results and clinical implications of the Dose Rounding Project?

In our Dose Rounding Project, we had a few goals. The first was to reduce waste, to try to save money, and make things more convenient and efficient. We have 2 rounding rules. The first rule is, if the dose is within 10% of the vial size, we round to the vial size, either up or down. If it's not, then we and a group of pharmacists sit down and we looked at like syringes, and what we did is we came up with easily measurable amounts. Anybody who's ever looked at a 60 ml syringe will realize that you're not gonna be able to measure 0.3 ml, and so we try to round it to 1 ml or 5 ml or whatever is important to make it easy to measure.

So when we did all of this, then we started looking at the cost savings, and we have 3 years worth of data now. What we've shown is 3 different areas. The first area is, how much did we save because we rounded down and we didn't open the next vial? We calculated the whole cost of the vial, and using average selling price, estimated that it's about $40 million over the course of 3 years. And that's consistent with some of the numbers we saw in our first 6 months. First 6 months, we estimated 15 [million dollars], now 3 years out, we're estimating about 40 [million dollars]. It's a little under $11 million, almost $12 million a dose. The next thing we looked at was, how much did we save because we rounded up to the vial size and we did not throw the drug away. Now, we're not really saving money here, we're just not wasting an amount of money. Over the 3-year period of time, that was just about $10 million. If you put those 2 in combination, the dose rounding impact was $50 million that we had an impact on drugs in some way.

The final piece that we did we present in our study is that we looked at what we're actually wasting and throwing away, and over the 3-year period of time, it was $25 million. That's drugs that we drew up, didn't do anything with, and threw away. About $8.5 million a year, that's kind of what we're looking at. So again, it comes back to, even though dose rounding has made a big impact, there's still more we can do, and we need to figure out how to get that last $8 to $9 million that we're not throwing away.

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