Cost minimization analysis of intravenous or subcutaneous trastuzumab treatment in patients with HER2-positive breast cancer in Ireland

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dc.contributor.author O'Brien, Gary L.
dc.contributor.author O'Mahony, Cian
dc.contributor.author Cooke, Katie
dc.contributor.author Kinneally, Ada
dc.contributor.author Sinnott, Sarah-Jo
dc.contributor.author Walshe, Valerie
dc.contributor.author Mulcahy, Mark
dc.contributor.author Byrne, Stephen
dc.date.accessioned 2019-03-22T10:06:34Z
dc.date.available 2019-03-22T10:06:34Z
dc.date.issued 2019-02-06
dc.identifier.citation O'Brien, G. L., O'Mahony, C., Cooke, K., Kinneally, A., Sinnott, S.-J., Walshe, V., Mulcahy, M. and Byrne, S. (2019) 'Cost minimization analysis of intravenous or subcutaneous trastuzumab treatment in patients with HER2-positive breast cancer in Ireland', Clinical Breast Cancer. doi:10.1016/j.clbc.2019.01.011 en
dc.identifier.startpage 1 en
dc.identifier.endpage 10 en
dc.identifier.issn 1526-8209
dc.identifier.issn 1938-0666
dc.identifier.uri http://hdl.handle.net/10468/7660
dc.identifier.doi 10.1016/j.clbc.2019.01.011
dc.description.abstract Background: 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. Materials and Methods: 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. Results: 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 â ¬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. Conclusion: 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. en
dc.description.sponsorship Irish Research Council (GOIPG/2016/635) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Elsevier Inc. en
dc.relation.uri http://www.sciencedirect.com/science/article/pii/S1526820918305263
dc.rights © 2019, Elsevier Ltd. All rights reserved. This manuscript version is made available under the CC BY-NC-ND 4.0 license. en
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/ en
dc.subject Administration routes en
dc.subject Cost analysis en
dc.subject Micro-costing en
dc.subject Oncology en
dc.subject Outpatient care en
dc.title Cost minimization analysis of intravenous or subcutaneous trastuzumab treatment in patients with HER2-positive breast cancer in Ireland en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Stephen Byrne, School Of Pharmacy, University College Cork, Cork, Ireland. +353-21-490-3000 Email: stephen.byrne@ucc.ie en
dc.internal.availability Full text available en
dc.check.info Access to this article is restricted until 12 months after publication by request of the publisher. en
dc.check.date 2020-02-06
dc.date.updated 2019-03-22T09:56:30Z
dc.description.version Accepted Version en
dc.internal.rssid 478578916
dc.contributor.funder Irish Research Council en
dc.contributor.funder Leading Edge Group Ltd., Ireland
dc.description.status Peer reviewed en
dc.identifier.journaltitle Clinical Breast Cancer en
dc.internal.copyrightchecked Yes en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress stephen.byrne@ucc.ie en
dc.internal.bibliocheck In press. Check vol / issue / page range. Amend citation as necessary.


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© 2019, Elsevier Ltd. All rights reserved. This manuscript version is made available under the CC BY-NC-ND 4.0 license. Except where otherwise noted, this item's license is described as © 2019, Elsevier Ltd. All rights reserved. This manuscript version is made available under the CC BY-NC-ND 4.0 license.
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