Make six-weekly immunotherapy the default schedule
Pembrolizumab 400 mg every six weeks is approved and works like 200 mg every three weeks, and it halves the number of clinic visits, infusion chairs and travel days without changing the drug bill.
Overview
The FDA approved pembrolizumab 400 mg every six weeks in 2020 on pharmacokinetic modelling and later clinical data; nivolumab 480 mg every four weeks has a similar basis. The drug quantity is the same, so the saving is in administration fees, chair time, staff, and patients' travel and time off work. Many practices still default to three-weekly schedules. A default schedule change in electronic order sets, with the shorter interval reserved for patients who need frequent review, is the cheapest capacity gain available in immunotherapy.
- Wrong doses · Most drug doses were chosen as the highest a person can tolerate, which is often more than they need.
- Fragmented care and guideline gaps · Patients fall between specialists, wait for referrals and often do not get the treatment guidelines say they should.
- Not enough oncologists, nurses, pathologists, physicists · The number of people with cancer is rising faster than the workforce trained to treat them.
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