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

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dc.contributor.authorO'Brien, Gary L.
dc.contributor.authorO'Mahony, Cian
dc.contributor.authorCooke, Katie
dc.contributor.authorKinneally, Ada
dc.contributor.authorSinnott, Sarah-Jo
dc.contributor.authorWalshe, Valerie
dc.contributor.authorMulcahy, Mark
dc.contributor.authorByrne, Stephen
dc.contributor.funderIrish Research Councilen
dc.contributor.funderLeading Edge Group Ltd., Ireland
dc.date.accessioned2019-03-22T10:06:34Z
dc.date.available2019-03-22T10:06:34Z
dc.date.issued2019-02-06
dc.date.updated2019-03-22T09:56:30Z
dc.description.abstractBackground: 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.sponsorshipIrish Research Council (GOIPG/2016/635)en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationO'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.2019.01.011en
dc.identifier.doi10.1016/j.clbc.2019.01.011
dc.identifier.endpage10en
dc.identifier.issn1526-8209
dc.identifier.issn1938-0666
dc.identifier.journaltitleClinical Breast Canceren
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/7660
dc.language.isoenen
dc.publisherElsevier Inc.en
dc.relation.urihttp://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.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectAdministration routesen
dc.subjectCost analysisen
dc.subjectMicro-costingen
dc.subjectOncologyen
dc.subjectOutpatient careen
dc.titleCost minimization analysis of intravenous or subcutaneous trastuzumab treatment in patients with HER2-positive breast cancer in Irelanden
dc.typeArticle (peer-reviewed)en
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