ISSN 1866-8836
Клеточная терапия и трансплантация

OI-03. Efficiency evaluation of forecasting the drug needs for allogeneic hematopoietic stem cell transplantation using a simulation method: The busulfan case study

Vadim V. Zubkov, Mikhail Yu. Drokov, Roza I. Yagudina, Tatiana I. Kupriyanenko, Galina A. Arkhipova, Larisa A. Kuzmina, Elena N. Parovichnikova

National Research Center for Hematology, Moscow, Russia; Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia

Contact: Dr. Vadim V. Zubkov, e-mail:

doi 10.18620/ctt-1866-8836-2020-9-3-1-152



Forecasting drugs needs by healthcare professionals is one of the most important elements of drug provision, including in allogeneic hematopoietic stem cell transplantation (allo-HSCT). Within the conditions of increase in budget expenditures for the provision of medical care, the necessity to search for new more accurate forecasting methods that could, on the one hand, prevent drug shortages, and, on the other hand, prevent their “write-off” after the expiration date, is becoming more acute. The poor knowledge of this issue and the use of mainly “intuitive” methods and expert assessments for forecasting predetermined the goal of this study. Our objective was to evaluate suitability of the simulation method for determining the need for drugs using busulfan as typical example of purchases in hematological clinics.

Materials and methods

To create a simulation model, we used the anthropometric data of 102 patients with hematological malignancies, who underwent allo-HSCT at the National Medical Research Center of Hematology over the period from 2017 to 2018. The body weight value among the patients was distributed according to the normal law (Kolmogorov-Smirnov test p=0.2). The simulation was carried out using the R language in R Studio software and the dplyr package. To increase accuracy, the simulation was run 1000 times. The need for 43 patients was predicted with a busulfan dosage regimen of 8 mg/kg. Likewise, the models were built with a progressive increase in the value of demand by 1-20%. The data on the real need for 2019 for pre-transplant conditioning with 8 mg/kg busulfan were used as a validation sample. The actual requirement for 43 patients in 2019 was 26,400 mg. To assess the quality of the forecast, the method of mean absolute deviation (MAD) was used, which was calculated as the absolute average value of difference between the “predicted” (simulation) and “actual” (data for 2019) cost values.


The principal results are shown in Fig. 1. When assessing quality of the forecast using the MAD method, it was found that the mean absolute deviation (MAD) was minimal, if using a simulation model with an increase in costs of 3%. In this case, the deviation from real indicators was 921 mg, while the maximum deviation was obtained using the model with an increase in costs by 20%, thus comprising 4627 mg of busulfan.


Figure 1. Sample calculation of busulfan requirements using MAD approach


As based on the results of this work, we can state that the simulation method for determining the need for medicines may be used to calculate the amount of a drug required for the purchase, with a minimal forecasting error.


Medical drugs, forecasting of needs, simulation, busulfan, allo-HSCT.

Volume 9, Number 3

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doi 10.18620/ctt-1866-8836-2020-9-3-1-152

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