Scientific Poster Session IV - Students Research-in-Progress

Students Research in Progress
  Tuesday, October 15, 2024
  08:30 AM–10:00 AM

Abstract

Introduction: Pembrolizumab and nivolumab have both been studied at weight-based dosing and fixed dosing, and both are currently FDA approval for fixed dosing. Fixed dosing was implemented to improve drug errors, but current studies have suggested increased drug cost. Dose minimization may result in less drug waste and therefore more cost savings. This strategy involves using weight-based dosing up to certain cutoffs (pembrolizumab use < 100 kg, nivolumab use < 80 kg).

Research Question or Hypothesis: For patients receiving pembrolizumab or nivolumab infusion that qualify for weight-based dosing, what are the cost savings of dose minimization?

Study Design: Medication use evaluation of nivolumab and pembrolizumab utilization from 6/1/2023 through 5/31/2024.

Methods: Pembrolizumab and nivolumab 12-month utilization was obtained through electronic health record system at a large academic medical center. Data was pulled from four outpatient infusion centers. All adult patients receiving pembrolizumab or nivolumab were evaluated. Exclusion criteria included patients =18 years old and no documented weight. Analysis was conducted comparing fixed-dosing and weight-based dosing. Weight-based dosing was further categorized assuming open schedule (scheduled on any day) and scheduling on the same day. Outcomes assessed included baseline characteristics, difference in number of vials by location, and potential cost-savings.

Results:

Nivolumab research in progress.

	Pembrolizumab
	Annual Total Vials Saved	Annual Total Cost-Savings (AWP)
Dose minimization1	440	$2,933,760
Scheduling2	1000	$6,804,000

1. Weight-based dosing versus fixed dosing

2. Weight-based dosing for patients scheduled on the same day

Conclusion: Pembrolizumab dose minimization, regardless of scheduling, is cost effective. Nivolumab research is still in progress, but current research is showing less cost effectiveness. Overestimation and assumptions are a limitation of this study. These limits include staffing, available beds, assuming ease of vials used, and not including rounded doses. Despite overestimation with both groups, pembrolizumab is being assessed due to its convincing cost-savings.

Presenting Author

Aaron Kurpgeweit Student
University of Nebraska Medical Center

Authors

Stephanie Johnson Pharm.D., BCOP
Nebraska Medicine

Sara Kjerengtroen PharmD, BCPS
Nebraska Medicine

Chao Yuan Ku PharmD
Nebraska Medicine

Alex Olinger Pharm.D., BCPS, BCOP
Nebraska Medicine