Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland.
Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland.
Clin Breast Cancer. 2019 Jun;19(3):e440-e451. doi: 10.1016/j.clbc.2019.01.011. Epub 2019 Feb 6.
Two large acute Irish University teaching hospitals changed the manner in which they treated human epidermal growth factor receptor (HER)2-positive breast cancer patients by implementing the administration of trastuzumab via the subcutaneous (SC) route into their clinical practice. The study objective is to compare the trastuzumab SC and trastuzuamb intravenous (IV) treatment pathways in both hospitals and assess which route is more cost-effective and time saving in relation to active health care professional (HCP) time.
A prospective observational study in the form of cost minimization analysis constituted the study design. Active HCP time for trastuzumab SC- and IV-related tasks were recorded. Staff costs were calculated using fully loaded salary costs. Loss of productivity costs for patients were calculated using the human capital method.
On average, the total HCP time saved per trastuzumab SC treatment cycle relative to trastuzumab IV treatment cycle was 59.21 minutes. Time savings in favor of trastuzumab SC resulted from quicker drug reconstitution, no IV catheter installation/removal, and less HCP monitoring. Over a full treatment course of 17 cycles, average HCP time saved accumulates to 16.78 hours, with an estimated direct cost saving of €1609.99. Loss of productivity for patients receiving trastuzumab IV (2.15 days) was greater than that of trastuzumab SC (0.60 days) for a full treatment course.
Trastuzumab SC treatment has proven to be a more cost-effective option than trastuzumab IV treatment that generated greater HCP time savings in both study sites. Healthcare policymakers should consider replacing trastuzumab IV with trastuzumab SC treatment in all eligible patients.
两家大型爱尔兰国立教学医院改变了曲妥珠单抗的给药方式，将其从静脉输注（IV）改为皮下（SC）注射，以治疗人表皮生长因子受体（HER）2 阳性乳腺癌患者。本研究旨在比较两家医院的曲妥珠单抗 SC 和 IV 治疗途径，并评估哪种途径在与卫生保健专业人员（HCP）时间相关时更具成本效益和节省时间。
采用成本最小化分析的前瞻性观察性研究设计。记录曲妥珠单抗 SC 和 IV 相关任务的 HCP 主动时间。使用全额薪酬成本计算员工成本。使用人力资本法计算患者的生产力损失成本。
平均而言，与曲妥珠单抗 IV 治疗周期相比，每周期曲妥珠单抗 SC 治疗的 HCP 总时间节省了 59.21 分钟。曲妥珠单抗 SC 治疗的时间优势来自于更快的药物复溶、无需安装/移除静脉导管以及更少的 HCP 监测。在 17 个完整治疗周期中，平均 HCP 时间节省累计达 16.78 小时，估计直接成本节省 1609.99 欧元。接受曲妥珠单抗 IV 治疗的患者（2.15 天）的生产力损失大于接受曲妥珠单抗 SC 治疗的患者（0.60 天）。
与曲妥珠单抗 IV 治疗相比，曲妥珠单抗 SC 治疗更具成本效益，在两个研究地点均能节省更多的 HCP 时间。医疗保健政策制定者应考虑在所有符合条件的患者中用曲妥珠单抗 SC 治疗替代曲妥珠单抗 IV 治疗。
