Hospital de Cruces, Vizcaya, Spain.
Hospital Nuestra Señora de Valme, Sevilla, Spain.
Clin Transl Oncol. 2017 Dec;19(12):1454-1461. doi: 10.1007/s12094-017-1684-4. Epub 2017 Jun 2.
To describe healthcare professional (HCP) and patient time and related costs associated with trastuzumab intravenous infusion (IV) and trastuzumab subcutaneous (SC) formulations in patients with HER2-positive early breast cancer.
This prospective, observational time, and motion study in three Spanish centers was run as a substudy of the PrefHer trial. We recorded active HCP time for trastuzumab SC and IV-related tasks and calculated HCP time as the mean sum of task times over 154 administrations (80 IV, 74 SC). We calculated mean patient infusion chair time and treatment room time. Staff costs were calculated using fully loaded salary costs based on Spanish salaries (€ 2012).
The transition from trastuzumab IV to SC led to a 50% reduction in active HCP time [27.2 min (95% CI 21.8-32.6) vs. 13.2 min (95% CI 8.9-17.5) per cycle]. Time savings resulted from avoiding IV catheter installation and removal, line flushing, and drug reconstitution. SC administration led to a fivefold reduction (78-85%) in chair time and a fourfold reduction (59-81%) in patient treatment room time, resulting in 24 h free-up time in the total treatment course (18 cycles). Total estimated direct costs were € 29,431.75 and € 28,452.12 for IV and SC, respectively, a saving of € 979.60 over a full treatment course.
Trastuzumab SC provided substantial time savings for HCP and patients, and reduced staff costs vs. trastuzumab IV. Reducing the use of hospital facilities may result in further savings and improved quality of medical care.
描述曲妥珠单抗静脉输注（IV）和曲妥珠单抗皮下（SC）制剂在 HER2 阳性早期乳腺癌患者中与医疗保健专业人员（HCP）和患者时间及相关成本相关的情况。
这是在西班牙的三个中心进行的一项前瞻性、观察性时间和动作研究，作为 PrefHer 试验的子研究。我们记录了曲妥珠单抗 SC 和 IV 相关任务的 HCP 活跃时间，并将 HCP 时间计算为 154 次给药（80 次 IV，74 次 SC）中任务时间的平均值总和。我们计算了平均患者输注椅时间和治疗室时间。根据西班牙工资（2012 年欧元），使用全职薪酬成本计算了员工成本。
从曲妥珠单抗 IV 转换为 SC 导致 HCP 活跃时间减少 50%[每周期 27.2 分钟（95%CI 21.8-32.6）与 13.2 分钟（95%CI 8.9-17.5）]。时间节省来自于避免 IV 导管安装和移除、管路冲洗和药物复溶。SC 给药导致椅子时间减少五倍（78-85%），患者治疗室时间减少四倍（59-81%），总治疗过程（18 个周期）中有 24 小时空闲时间。总估计直接成本分别为 IV 为 29431.75 欧元和 SC 为 28452.12 欧元，整个治疗过程节省 979.60 欧元。
与曲妥珠单抗 IV 相比，曲妥珠单抗 SC 为 HCP 和患者提供了大量的时间节省，并降低了员工成本。减少医院设施的使用可能会带来进一步的节省和提高医疗质量。
