Merck Canada Inc., Kirkland, QC, Canada.
Evidence Synthesis, Evidera, The Ark, 201 Talgarth Rd, London, W6 8BJ, UK.
Adv Ther. 2024 Dec;41(12):4396-4417. doi: 10.1007/s12325-024-02985-9. Epub 2024 Oct 19.
While patients with cancer have traditionally received oncology treatments through intravenous (IV) administration, some therapies are becoming available via alternative modes of administration, such as subcutaneous (SC). This study aimed to evaluate IV versus SC therapy administration from the perspectives of the patient, healthcare provider (HCP), and healthcare system.
A systematic review was conducted, searching MEDLINE and Embase databases from 2000 to 2022. This was supplemented with grey literature searches of additional sources such as conference proceedings. Observational studies and clinical trials were included if they assessed adult patients with any cancer type who were treated with pharmacologic therapies administered via IV or SC and included patient- or HCP-reported outcomes or healthcare system perspectives on the mode of administration. Records identified by the literature search were screened by two independent reviewers. Included studies were data extracted by a single reviewer and validated by a second reviewer and synthesized using a narrative approach.
After screening, 33 unique studies were included in the systematic review. Patients and HCPs reported substantially more favorable preference rates for SC over IV treatment. Additionally, from the patient perspective there were reductions in treatment time and economic burden for SC compared with IV therapy. From the HCP's perspective, treatment time was consistently reduced by SC compared with IV treatment administration. Although information on the impact of SC and IV treatments for oncology on healthcare systems was limited, the use of SC formulations showed consistent cost savings (direct costs) and time savings from this perspective considering various uptake scenarios compared with IV administration.
Compared with IV administration, SC oncology treatment is a preferred option by patients and HCPs, increasing optionality and reducing treatment time while simultaneously increasing capacity and reducing the financial burden on healthcare systems.
虽然癌症患者传统上通过静脉（IV）给药接受肿瘤学治疗，但一些疗法可通过替代给药方式获得，如皮下（SC）。本研究旨在从患者、医疗保健提供者（HCP）和医疗保健系统的角度评估 IV 与 SC 治疗的给药方式。
对 2000 年至 2022 年期间的 MEDLINE 和 Embase 数据库进行了系统检索，并补充了会议记录等其他来源的灰色文献检索。如果观察性研究和临床试验评估了接受 IV 或 SC 给药的任何癌症类型的成年患者，并包括患者或 HCP 报告的结局或关于给药方式的医疗保健系统观点，则纳入这些研究。通过两名独立评审员筛选文献检索中确定的记录。纳入的研究由一名评审员提取数据，并由第二名评审员验证，并使用叙述方法进行综合。
经过筛选，系统评价纳入了 33 项独特的研究。患者和 HCP 报告对 SC 治疗的偏好率明显高于 IV 治疗。此外，与 IV 治疗相比，SC 治疗可减少治疗时间和经济负担。从 HCP 的角度来看，与 IV 治疗给药相比，SC 始终减少了治疗时间。尽管有关 SC 和 IV 治疗对肿瘤学的影响的信息有限，但从各种采用情况来看，与 IV 给药相比，SC 制剂的使用显示出一致的成本节约（直接成本）和时间节约。
与 IV 给药相比，SC 肿瘤学治疗是患者和 HCP 的首选方案，增加了选择性，减少了治疗时间，同时增加了容量并减轻了医疗保健系统的财务负担。
