A Cost Savings Quality Improvement Assessment of Rasburicase Dosing for Tumor Lysis Syndrome
by Mark T. Moua, PharmD, Emily Roland, PharmD, BCPS, Connie Folz, PharmD, BCPS, Sara Griesbach, PharmD, BCPS, BCACP
Abstract:
Background:
Rasburicase is an effective but expensive medication for the treatment of tumor lysis syndrome. With most recent guidelines published in 2008, guidance for rasburicase use is dated. This quality improvement project assesses the current prescribing practices for rasburicase and advocates for cost-effective care through standardizing dosing based on the current literature. Pharmacists can help ensure the proper indication, dosing, and administration of this medication, especially considering the associated cost of the drug.
Methods:
This retrospective, multi-centered quality improvement project included a medication use assessment of rasburicase prescribed for adult patients between January 1, 2022, and July 31, 2023. Data extraction included patient age, malignancy diagnosis, uric acid level prior to rasburicase administration, dose of rasburicase prescribed, prescriber specialty and name, and uric acid level post-administration.
Results:
Over the study period, rasburicase was ordered 79 times for a variety of malignancies. There were 31 incidents where rasburicase was ordered by a physician outside hematology-oncology. Sixty-one of the 79 orders were dosed for 6 mg; however, 56 orders could have been optimized based on the uric acid level prior to rasburicase administration.
Conclusions:
By standardizing rasburicase dosing, the institution could have utilized significantly less rasburicase within the studied period, resulting in an estimated annual cost savings of $50,000. Through implementation of dosing recommendations within an electronic medical record, pharmacists can help to ensure proper dosing and promote cost-considerate care.
Keywords: rasburicase, tumor lysis syndrome, dosing, fixed dose regimen, cost savings
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2025 May/June Table of Contents
Abstract:
Background:
Rasburicase is an effective but expensive medication for the treatment of tumor lysis syndrome. With most recent guidelines published in 2008, guidance for rasburicase use is dated. This quality improvement project assesses the current prescribing practices for rasburicase and advocates for cost-effective care through standardizing dosing based on the current literature. Pharmacists can help ensure the proper indication, dosing, and administration of this medication, especially considering the associated cost of the drug.
Methods:
This retrospective, multi-centered quality improvement project included a medication use assessment of rasburicase prescribed for adult patients between January 1, 2022, and July 31, 2023. Data extraction included patient age, malignancy diagnosis, uric acid level prior to rasburicase administration, dose of rasburicase prescribed, prescriber specialty and name, and uric acid level post-administration.
Results:
Over the study period, rasburicase was ordered 79 times for a variety of malignancies. There were 31 incidents where rasburicase was ordered by a physician outside hematology-oncology. Sixty-one of the 79 orders were dosed for 6 mg; however, 56 orders could have been optimized based on the uric acid level prior to rasburicase administration.
Conclusions:
By standardizing rasburicase dosing, the institution could have utilized significantly less rasburicase within the studied period, resulting in an estimated annual cost savings of $50,000. Through implementation of dosing recommendations within an electronic medical record, pharmacists can help to ensure proper dosing and promote cost-considerate care.
Keywords: rasburicase, tumor lysis syndrome, dosing, fixed dose regimen, cost savings
Download PDF
2025 May/June Table of Contents