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评估癌症患者皮下和静脉使用生物技术药物的经济效益、管理时间和患者偏好:系统评价。

Evaluation of the economic benefits, administration times, and patient preferences associated with the use of biotechnological drugs administered subcutaneously and intravenously in patients with cancer: a systematic review.

机构信息

Evidence-Based Medicine Department, NeuroEconomix, Bogotá, Colombia.

Evidence Generation Lead. Productos Roche S.A. Bogotá, Bogotá, Colombia.

出版信息

Expert Rev Pharmacoecon Outcomes Res. 2023 Jul-Dec;23(9):1017-1026. doi: 10.1080/14737167.2023.2249232. Epub 2023 Sep 4.

Abstract

INTRODUCTION

Cancer imposes a high economic burden with medical care and medication costs. We evaluate the costs, the use of resources, the administration time, and the patient preferences associated with the use of biotechnological drugs in SC and IV presentations.

METHODOLOGY

A systematic literature search was conducted in PubMed, Embase, and seven additional databases. The search was carried out in September 2021 and included only studies directly comparing SC and IV presentations. Evidence was synthesized narratively.

RESULTS

34 references were included, which only analyzed bortezomib, daratumumab, rituximab, and trastuzumab. Reduction in preparation costs of SC compared to IV presentations ranged from 6.6% to 50.1%, and in administration costs from 4.5% to 95.3%. SC administration of rituximab and trastuzumab resulted in less productivity loss. More than 68% of patients reported greater satisfaction with the SC route. A reduction of time in the infusion chair, lower costs of resources for preparation, and health personnel for the administration process were identified with SC administration.

CONCLUSIONS

The use of SC daratumumab, rituximab, and trastuzumab in patients with cancer reduces direct and indirect costs and adverse events compared to IV use. Patients prefer the SC administration, perceiving more comfort, and less pain at the administration site.

摘要

简介

癌症给医疗保健和药物治疗带来了高昂的经济负担。我们评估了与生物科技药物的皮下和静脉注射两种剂型相关的成本、资源利用、管理时间以及患者偏好。

方法

在 PubMed、Embase 和另外七个数据库中进行了系统文献检索。搜索于 2021 年 9 月进行,仅包括直接比较皮下和静脉注射剂型的研究。通过叙述性综合证据。

结果

共纳入 34 篇参考文献,仅分析了硼替佐米、达雷妥尤单抗、利妥昔单抗和曲妥珠单抗。与静脉注射剂型相比,皮下注射剂型的准备成本降低了 6.6%至 50.1%,管理成本降低了 4.5%至 95.3%。与静脉注射剂型相比,皮下注射利妥昔单抗和曲妥珠单抗导致生产力损失减少。超过 68%的患者报告对皮下注射途径更满意。与静脉注射剂型相比,皮下注射可减少输注椅上的时间、降低准备资源成本以及管理过程中的卫生人员成本。

结论

与静脉使用相比,癌症患者使用皮下注射的达雷妥尤单抗、利妥昔单抗和曲妥珠单抗可降低直接和间接成本以及不良反应。患者更喜欢皮下注射,认为在给药部位的舒适度更高,疼痛更小。

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