A framework for economic evaluation of therapeutic drug monitoring—guided dosing in oncology

Abstract The standard approach for dose individualization of chemotherapy in the oncology setting has long been based on body surface area (BSA) as a measure of body size. However, for many anticancer drugs, administration of dosages based on BSA may result in some patients receiving supratherapeuti...

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Autores principales:	Daniel Erku, Jennifer Schneider, Paul Scuffham
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	cost‐effectiveness economic evaluation oncology therapeutic drug monitoring Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/4cb74d7419184c139d1f9e507ac548a9
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spelling	oai:doaj.org-article:4cb74d7419184c139d1f9e507ac548a92021-11-16T13:45:56ZA framework for economic evaluation of therapeutic drug monitoring—guided dosing in oncology2052-170710.1002/prp2.862https://doaj.org/article/4cb74d7419184c139d1f9e507ac548a92021-10-01T00:00:00Zhttps://doi.org/10.1002/prp2.862https://doaj.org/toc/2052-1707Abstract The standard approach for dose individualization of chemotherapy in the oncology setting has long been based on body surface area (BSA) as a measure of body size. However, for many anticancer drugs, administration of dosages based on BSA may result in some patients receiving supratherapeutic or subtherapeutic concentrations due to substantial interindividual pharmacokinetic variability. Therapeutic drug monitoring (TDM)–guided dosing aims to ensure that the patient's serum drug concentration is in a target range which has been shown to produce optimal clinical outcomes. The management of several malignancies is now moving away from using traditional intravenous chemotherapy to longer‐term treatment with targeted molecular therapies. These targeted anticancer drugs are currently dosed based on a fixed dose for all patients. The pharmacokinetic characteristics of most of these drugs (e.g., tyrosine‐kinase inhibitors) support implementation of individualized dosing via TDM. However, prior to adopting TDM–guided dosing in oncology settings, the economic efficiency and value for money of introducing TDM interventions should be critically and systematically examined along with the impacts on patient care and outcomes. Yet, current evidence in this area is limited, and more generally, there is lack of methodological guidance on how to identify, estimate and value clinical and cost information necessary to conduct economic evaluations of TDM interventions. In this paper, we propose a coherent framework for conducting economic evaluation of TDM interventions in oncology settings and discuss some practical challenges of conducting economic evaluations of TDM.Daniel ErkuJennifer SchneiderPaul ScuffhamWileyarticlecost‐effectivenesseconomic evaluationoncologytherapeutic drug monitoringTherapeutics. PharmacologyRM1-950ENPharmacology Research & Perspectives, Vol 9, Iss 5, Pp n/a-n/a (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cost‐effectiveness economic evaluation oncology therapeutic drug monitoring Therapeutics. Pharmacology RM1-950
spellingShingle	cost‐effectiveness economic evaluation oncology therapeutic drug monitoring Therapeutics. Pharmacology RM1-950 Daniel Erku Jennifer Schneider Paul Scuffham A framework for economic evaluation of therapeutic drug monitoring—guided dosing in oncology
description	Abstract The standard approach for dose individualization of chemotherapy in the oncology setting has long been based on body surface area (BSA) as a measure of body size. However, for many anticancer drugs, administration of dosages based on BSA may result in some patients receiving supratherapeutic or subtherapeutic concentrations due to substantial interindividual pharmacokinetic variability. Therapeutic drug monitoring (TDM)–guided dosing aims to ensure that the patient's serum drug concentration is in a target range which has been shown to produce optimal clinical outcomes. The management of several malignancies is now moving away from using traditional intravenous chemotherapy to longer‐term treatment with targeted molecular therapies. These targeted anticancer drugs are currently dosed based on a fixed dose for all patients. The pharmacokinetic characteristics of most of these drugs (e.g., tyrosine‐kinase inhibitors) support implementation of individualized dosing via TDM. However, prior to adopting TDM–guided dosing in oncology settings, the economic efficiency and value for money of introducing TDM interventions should be critically and systematically examined along with the impacts on patient care and outcomes. Yet, current evidence in this area is limited, and more generally, there is lack of methodological guidance on how to identify, estimate and value clinical and cost information necessary to conduct economic evaluations of TDM interventions. In this paper, we propose a coherent framework for conducting economic evaluation of TDM interventions in oncology settings and discuss some practical challenges of conducting economic evaluations of TDM.
format	article
author	Daniel Erku Jennifer Schneider Paul Scuffham
author_facet	Daniel Erku Jennifer Schneider Paul Scuffham
author_sort	Daniel Erku
title	A framework for economic evaluation of therapeutic drug monitoring—guided dosing in oncology
title_short	A framework for economic evaluation of therapeutic drug monitoring—guided dosing in oncology
title_full	A framework for economic evaluation of therapeutic drug monitoring—guided dosing in oncology
title_fullStr	A framework for economic evaluation of therapeutic drug monitoring—guided dosing in oncology
title_full_unstemmed	A framework for economic evaluation of therapeutic drug monitoring—guided dosing in oncology
title_sort	framework for economic evaluation of therapeutic drug monitoring—guided dosing in oncology
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/4cb74d7419184c139d1f9e507ac548a9
work_keys_str_mv	AT danielerku aframeworkforeconomicevaluationoftherapeuticdrugmonitoringguideddosinginoncology AT jenniferschneider aframeworkforeconomicevaluationoftherapeuticdrugmonitoringguideddosinginoncology AT paulscuffham aframeworkforeconomicevaluationoftherapeuticdrugmonitoringguideddosinginoncology AT danielerku frameworkforeconomicevaluationoftherapeuticdrugmonitoringguideddosinginoncology AT jenniferschneider frameworkforeconomicevaluationoftherapeuticdrugmonitoringguideddosinginoncology AT paulscuffham frameworkforeconomicevaluationoftherapeuticdrugmonitoringguideddosinginoncology
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A framework for economic evaluation of therapeutic drug monitoring—guided dosing in oncology

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