SC rituximab was associated with reduced active HCP time and costs vs IV rituximab, as well as reduced patient time in the treatment room. Switching from IV to SC rituximab could increase treatment room capacity and patient throughput, as well as improving the patient experience.

Aim: Firstly, to quantify active healthcare professional (HCP) time and costs associated with subcutaneous (SC) administration of trastuzumab (Herceptin ® ) compared with the standard intravenous infusion (IV) in the treatment of patients with HER2-positive early breast cancer within the adjuvant PrefHer trial setting; secondly, to measure patient time in the care unit and patient infusion chair time for both routes of administration. Methods: A UK multi-centre prospective, observational Time and Motion study was conducted alongside the PrefHer trial (ClinicalTrials.gov id: NCT01401166). Trained observers measured the duration of each SC and IV related task that HCPs undertook and recorded patient time in the chemotherapy unit and infusion chair. The type and quantity of medical consumables used with each route of administration were also collected. Twenty-four patient episodes were recorded (12 SC, 12 IV). Mean total administration time was calculated as the mean sum of task times, both for IV and SC formulations. The mean cost of each route of administration was calculated as the mean cost of HCP time plus the mean cost of consumables used. HCP time was costed using Personal Social Services Research Unit. Consumables were costed using hospital pharmacy data and online sources. Results: Mean active HCP time for IV administration was 92.6 minutes compared with 24.6 minutes for SC administration. The mean cost for IV preparation and administration was £144.96 (£132.05 of HCP time and £12.92 of consumables) versus £33.15 (£31.99 of HCP time and £1.17 of consumables) for SC administration. Mean time spent in the care unit and in the infusion chair was 94.5 minutes and 75 minutes respectively for IV, and 30.3 minutes and 19.8 minutes for SC. SC administration of trastuzumab could translate to a time saving of 68 minutes (versus IV) with a total cost saving of £111.81 per patient episode. This equates to a potential saving of £2012.58 over a full course of adjuvant treatment (18 cycles). Conclusion: Substituting IV infusion with SC administration of trastuzumab may lead to a substantial reduction in active HCP time, patient chair and unit time, consumable use and overall costs. The reduced patient chair and unit time could provide increased capacity within existing resources.

Not all possible presentations of aBCC were included; the disease is a challenging condition to characterise given its rarity, the nature of the patients affected, and its variable progression. Findings suggest that aBCC is associated with significant burden for individuals, even when their disease is stable or where surgical treatment has been successful.

Chronic lymphocytic leukemia (CLL) is a largely incurable disease which affects patients' health related quality of life (HRQL). Treatment is often initiated when symptoms affect HRQL, and patients can experience many rounds of treatment throughout their life. Therefore, the economic burden of CLL can be high. Utility or preference weights for health states reflect the value of HRQL of a given health state and range from 1 (full health) to 0 (dead) and below (negative values possible). Nine health states were developed representing different CLL treatment lines or disease stages. One hundred members of the UK general public valued each health state using the time trade-off methodology. Progression-free survival (PFS) without therapy (mean utility = 0.82) was the least burdensome, with relapsed lines of treatment (mean utility = 0.42) representing the greatest burden. The results underline the value in maintaining a state of PFS for as long as possible.

patients included in these studies was 118 patients (min: 30, max: 724). On average, median PFS/TTP was 14.0 months (sdϭ12.4) and median OS was 35.0 months (sdϭ31.2). Results of the correlation analysis indicated that median PFS/TTP is highly correlated with median OS, with a Spearman's correlation coefficient of 0.813 (pՅ0.001). A significant correlation between median PFS/TTP and median OS was observed in the second-line and subsequent-line therapies, but not in the first-line setting. CONCLUSIONS: The present results demonstrate a very strong correlation between median PFS/TTP and median OS in the context of CLL, which reinforce the hypothesis that PFS/TTP would be adequate surrogate endpoints for OS in this cancer setting.

No abstract

GClb was estimated to increase both quality-adjusted life expectancy and treatment costs compared with several commonly used therapies, with incremental cost-effectiveness ratios below commonly referenced UK thresholds. This article offers a real example of how to combine direct and indirect evidence in a cost-effectiveness analysis of oncology drugs.

is associated with decreased quality of life, and poorer health outcomes. Therefore, there may be considerable gains in the adequate treatment of depression in oncology patients. We explored the cost-effectiveness of a collaborative care intervention specifically developed for the treatment of depression in cancer patients compared to usual practice. Methods: A cost-effectiveness analysis comparing a collaborative care intervention for depression management, Depression Care for People with Cancer (DCPC), in addition to usual care with usual care alone, based on data from the second Symptom Management Research Trials in Oncology (SMaRT-2). SMaRT-2 was a large (n= 500), multicentre study, in depressed patients with a relatively good cancer prognosis, in a secondary care setting. Outcomes included costs expressed as UK sterling in 2010-11 prices and health outcomes in quality-adjusted life-years (QALYs), estimated from a National Health Service and Personal Social Services perspective. Scenario analyses were performed to determine the impact on cost-effectiveness of alternative costing assumptions, and uncertainty was characterised through cost-effectiveness acceptability curves and probabilities of cost-effectiveness at key cost-effectiveness thresholds. Results: DCPC in addition to usual care was associated with greater costs, but also improved health outcomes. DCPC was found to be cost-effective at accepted cost-effectiveness thresholds. Results were robust across alternative scenarios, with probabilities of cost-effectiveness higher than 90% for cost-effectiveness thresholds ranging between £20,000-30,000 per QALY. ConClusions: Compared to usual care, DCPC in addition to usual care is likely to be cost-effective at current UK cost-effectiveness thresholds. This contributes to the growing evidence on the cost-effectiveness of collaborative care interventions for the treatment of comorbid depression. Future research will use a decision modelling approach to extrapolate trial-based results across a longer time horizon, and incorporate other relevant sources of evidence.