Cost savings of home bortezomib injection in patients with multiple myeloma treated by a combination care in Outpatient Hospital and Hospital care at Home

Abstract

At home injectable chemotherapy for patients receiving treatment for hematological diseases is still in debate. Given the expense of new innovative medicines, at home treatment has been proposed as a suitable option for improving patient quality of life and decreasing treatment costs. We decided to assess the cost of bortezomib administration in France among multiple myeloma patients from an economic standpoint. Patients in this study were treated within a regional hematological network combining outpatient hospital care and Hospital care at Home administration. To make the cost comparison, our team simulated outpatient hospital care expenses. Fifty-four consecutive multiple myeloma patients who received at least one injection of bortezomib in Hospital care at Home from January 2009 to December 2011 were included in the study. The median number of injections was 12 (range 1–44) at home and 6 (range 0–30) in the outpatient care unit. When compared with the cost simulation of outpatient hospital care alone, bortezomib administration with combined care was significantly less expensive for the National Health Insurance (NHI) budget. The mean total cost per patient and per injection was 954.20 € for combined outpatient and Hospital care at Home vs 1143.42 € for outpatient hospital care alone. This resulted in an estimated 16.5 % cost saving (Wilcoxon signed-rank test, p < 0.0001). The greatest savings were observed in administration costs (37.5 % less) and transportation costs (68.1 % less). This study reflects results for a regionally implemented program for multiple myeloma patients treated with bortezomib in routine practice in a large rural area.Electronic supplementary materialThe online version of this article (doi:10.1007/s00520-016-3363-3) contains supplementary material, which is available to authorized users.

Interpreting clinical trial data in multiple myeloma: translating findings to the real-world setting

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Hospital-based or home-based administration of oncology drugs? A micro-costing study comparing healthcare and societal costs of hospital-based and home-based subcutaneous administration of trastuzumab

“…To our knowledge, there is limited evidence on healthcare and societal costs of home-based SC administration of oncology drugs. A recent systematic review [10] identified two studies [19,20] a For home-based administration, costs for the preparation of the injection related to the time of healthcare professionals and usage of consumables were included in costs for ready to use trastuzumab injection. b Costs of adminstrative staff (planner) in the hospital setting were included in the overhead costs (thus not in the active time of healthcare professionals).…”

Bortezomib‐based therapy for relapsed/refractory multiple myeloma in real‐world medical practice

“…Interpretation of data regarding resource utilization is limited due to differences in clinical practice and healthcare systems between the different countries participating in eVOBS. Although patients appeared to be managed predominantly in the outpatient setting in eVOBs, the subsequent introduction of subcutaneous bortezomib has enabled home administration which is cost‐saving as well as more cost‐effective and is preferred by patients . Furthermore, the recent advent of all‐oral regimens such as lenalidomide‐dexamethasone‐ixazomib has also increased patient convenience and the potential for home‐based management.…”

“…Although patients appeared to be managed predominantly in the outpatient setting in eVOBs, the subsequent introduction of subcutaneous bortezomib has enabled home administration which is cost-saving as well as more cost-effective and is preferred by patients. [38][39][40] Furthermore, the recent advent of all-oral regimens such as lenalidomidedexamethasone-ixazomib 41 has also increased patient convenience and the potential for home-based management.…”