Impact of the subcutaneous formulations of trastuzumab and rituximab on efficiency and resource optimization in Spanish hospitals: H-Excelencia study

Abstract

Background Subcutaneous (SC) versus intravenous (IV) administration is advantageous in terms of patient convenience and hospital efficiency. This study aimed to compare the effect of optimizing the processes involved in SC versus IV administration of rituximab and trastuzumab on hospital capacity and service quality. Methods This cross-sectional resource utilization study interviewed oncologists, hematologists, nurses, and pharmacists from 10 hospitals in Spain to estimate changes in processes associated with conversion from IV to SC rituximab and trastuzumab, based on clinical experience and healthcare use from administrative databases. Results Efficient use of SC formulations increased the monthly capacity for parenteral administration by 3.35% (potentially increasable by 5.75% with maximum possible conversion according to the product label). The weekly capacity for hospital pharmacy treatment preparation increased by 7.13% due to conversion to SC formulation and by 9.33% due to transferring SC preparation to the cancer treatment unit (potentially increasable by 12.16 and 14.10%, respectively). Monthly hospital time decreased by 33% with trastuzumab and 47% with rituximab. In a hypothetical hospital, in which all processes for efficient use of SC rituximab and/or trastuzumab were implemented and all eligible patients received SC formulations, the estimated monthly capacity for preparation and administration increased by 23.1% and estimated hospital times were reduced by 60–66%. Conclusions Conversion of trastuzumab and rituximab to SC administration could improve the efficiency of hospitals and optimize internal resource management processes, potentially increasing care capacity and improving the quality of care by reducing time spent by patients at hospitals.

Safety and tolerability of a 90‐minute rapid infusion of Sandoz biosimilar rituximab in B‐cell lymphoproliferative disorders in a real‐world setting

“…35 Subcutaneous rituximab is administered at a fixed-dose of 1400 mg and has also shown improvement in these factors, although this formulation is associated with higher costs and is not available in all centers. 5,7,36,37 Limitations of this analysis include the relatively small sample size of patients and SDZ-RTX infusions, as well as the retrospective nature of data collection on IRRs and their outcome. Despite these limitations, our study provides relevant clinical findings that could guide physicians considering introducing a 90-min SDZ-RTX infusion as a treatment option for hematologic malignancies.…”

“…rituximab infusions save an average of 10.2 h per patient over the course of rituximab treatment, thereby offering an economic advantage by reducing chair time, resource utilization, and nursing monitoring 35 . Subcutaneous rituximab is administered at a fixed‐dose of 1400 mg and has also shown improvement in these factors, although this formulation is associated with higher costs and is not available in all centers 5,7,36,37 …”

“… 35 Subcutaneous rituximab is administered at a fixed‐dose of 1400 mg and has also shown improvement in these factors, although this formulation is associated with higher costs and is not available in all centers. 5 , 7 , 36 , 37 …”

“…infusion varies across countries as shown in clinical and real‐world studies. 5 , 6 , 7 This labor‐intensive process is not only inconvenient and impacts quality of life for patients, but also consumes healthcare resources and reduces treatment capacity in day‐care units. Several studies have confirmed the favorable safety profile of rapid i.v.…”