PCN39 Potential Time and Cost Savings with Herceptin (Trastuzumab) Subcutaneous (SC) Injection Versus Herceptin Intravenous (IV) Infusion: Results from Three Different English Patient Settings

Samanta, Kunal; Moore, Laura J.; Jones, Graeme; Evason, J.; Owen, G

doi:10.1016/j.jval.2012.08.1232

Cited by 6 publications

(11 citation statements)

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“…Consistent with past studies, we found that the SC formulation of trastuzumab is cost saving compared to the IV formulation currently available in Malaysian MOH hospitals for the treatment of HER2+ early breast cancer [22] [23] [25]. Cost savings for a full course 17 cycles of treatment is estimated to be RM7561 from the MOH perspective to RM7820 from the societal perspective.…”

Section: Discussionsupporting

confidence: 82%

“…CMAs conducted from the perspective of the England and Wales NHS (₤2013), the Greek health system (€1121), and the Scottish NHS (£3454) have all reported cost savings over 1 year of treatment with SC trastuzumab [21] [23] [25]. In addition, an analysis by Samanta et al estimated cost savings of £271,000 and reduction of pharmacists and nurses workload by 5492 hours from switching a cohort of 200 breast cancer patients from IV to SC trastuzumab in the English NHS [22]. However, the magnitude of cost savings related to personnel costs seen in the European studies are not as apparent in our study due to the comparatively low salaries of MOH staff.…”

Section: Discussionmentioning

confidence: 99%

“…Costs incurred per patient for the full 1 year course of treatment with IV and SC trastuzumab were taken into consideration. This model was previously utilised in two other CMA studies of SC trastuzumab in England and Scotland [22] [25].…”

Section: Model Descriptionmentioning

confidence: 99%

“…Two studies from England and Greece used a modelling-based approach to simulate the time and cost savings [22] [23]. Samanta and colleagues investigated the cost consequences of switching a cohort of 200 breast cancer patients from IV to SC trastuzumab in the English NHS.…”

Section: Introductionmentioning

confidence: 99%

“…Samanta and colleagues investigated the cost consequences of switching a cohort of 200 breast cancer patients from IV to SC trastuzumab in the English NHS. The study estimated that over one year, switching to SC trastuzumab would result in a reduction of pharmacists and nurses workload by 5492 hours and generate cost savings of £271,000 [22]. Similarly, a study from Greece reported mean total cost per year of IV and SC trastuzumab was €24,163 and €23,042 per patient respectively; with the use of SC resulting in savings of €1121 [23].…”

Section: Introductionmentioning

confidence: 99%

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Economic Analysis of Intravenous vs. Subcutaneously Administered Trastuzumab for the Treatment of HER2+ Early Breast Cancer in Malaysia

Lee

Haron²,

Yu³

et al. 2016

ABCR

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Human epidermal growth factor receptor-2 over expression has been reported in 23% -37.3% of Malaysian breast cancer patients. Trastuzumab is a recommended adjuvant therapy for patients with early breast cancer. Currently, trastuzumab is administered intravenously but a new subcutaneous formulation could save time and costs. In Malaysia, the Ministry of Health funds most of the costs of secondary care, including cancer treatment. We performed a cost-minimisation analysis from the Ministry of Health and societal perspectives by adapting an excel-based mathematical model. Model inputs comprised of drug, consumables and personnel costs. Data sources were government statistics, price lists, government salary scales and estimated personnel time costs. Doctors, nurses and pharmacists at four hospitals estimated the time to perform necessary tasks following their usual practice. Results showed that subcutaneous trastuzumab could, on average, save an estimated 43.5 minutes of pharmacists' time and 11.6 minutes and 4.9 minutes of nurses' time administering loading dose and subsequent doses, respectively. Total cost savings were RM7561 (8.7%) per patient per year, consisting of RM6496 (7.6%) reduction in drug cost and RM1065 (66.2%) reduction in non-drug costs. Similarly, cost savings from the societal perspective were RM7820 per patient per year, comprising RM6496 (7.6%) and RM1325 (63.7%) of drug and non-drug costs savings, respectively. Sensitivity analyses showed that cost savings on subcutaneous formulation ranged from RM3715 to RM11408 to the Ministry of Health. Overall, subcutaneous trastuzumab is estimated * Corresponding author. W. C. Lee et al.2 to be cost-saving from Ministry of Health and societal perspectives. Other benefits from saving patients' and carers' time and convenience could not be taken into account. This study was a first to investigate cost-savings from subcutaneous trastuzumab in a middle-income Asian country and the findings were consistent with findings of earlier studies. Given the favourable impact on time and costs, subcutaneous trastuzumab should be considered a viable option for Malaysian patients.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Model Descriptionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Economic Analysis of Intravenous vs. Subcutaneously Administered Trastuzumab for the Treatment of HER2+ Early Breast Cancer in Malaysia

Lee

Haron²,

Yu³

et al. 2016

ABCR

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Subcutaneous trastuzumab: a review of its use in HER2-positive breast cancer

Sanford¹

2014

Targ Oncol

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Trastuzumab (Herceptin®) is a humanized IgG1 monoclonal antibody that is an efficacious treatment for HER2-positive breast and gastric cancers. Subcutaneous trastuzumab is a new formulation approved in the European Union for use in patients with early or metastatic breast cancer. In the randomized, open-label, multinational HannaH (enHANced treatment with NeoAdjuvant Herceptin) study of neoadjuvant/adjuvant trastuzumab in patients with early HER2-positive breast cancer, the pharmacokinetics of neoadjuvant subcutaneous trastuzumab were similar to those after intravenous administration, meeting the noninferiority criterion for mean predose trough concentrations, as assessed prior to surgery (primary pharmacokinetic endpoint). Trastuzumab blood concentrations throughout the dosing interval remained above those considered necessary for anticancer activity. In this study, the pathologic complete response rates (primary efficacy endpoint) were 45.4 and 40.7 % in the subcutaneous and intravenous administration groups, respectively, meeting a study noninferiority criterion. In the randomized, open-label, crossover, multinational PrefHer study of neoadjuvant/adjuvant or adjuvant trastuzumab in early HER2-positive breast cancer, subcutaneous administration of trastuzumab was preferred over intravenous administration by >85 % of patients, most commonly because it was time saving and induced less pain and discomfort. In the HannaH study, the tolerability profile of subcutaneous trastuzumab was similar to that of intravenous trastuzumab, except that the rate of serious adverse events was 21 % (vs. 12 % with intravenous administration), partly because of more infections with subcutaneous administration. Whether this finding is of any clinical significance should emerge from ongoing studies. On the evidence, subcutaneous trastuzumab is an effective and generally well-tolerated treatment option that is preferred by patients over intravenous administration.

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Development of New Formulations of Biologics: Expectations, Immunogenicity, and Safety for Subcutaneous Trastuzumab

et al. 2018

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Subcutaneous (SC) trastuzumab has long been approved as a cancer treatment for early and advanced HER2-positive (HER2+) breast cancer by both the European Medicines Agency (EMA) and Agência Nacional de Vigilância Sanitária (ANVISA), the Brazilian National Health Surveillance Agency. A pivotal non-inferiority phase III trial, which aimed to provide a more convenient and cost-effective treatment in the HER2+ breast cancer neoadjuvant setting, showed that the SC group met prespecified efficacy endpoints and the SC formulation was considered as safe as the intravenous (IV) formulation. Considering the recent approval of several biosimilars, new SC formulations are also an interesting manufacturer strategy as these drugs can obtain patent protection. Despite being considered non-inferior to the IV formulation of trastuzumab, in clinical development, the SC formulation elicited higher immunogenicity, mainly related to overall anti-drug antibodies (ADAs); however, this finding was classified as clinically non-significant. In this article, we explore different aspects of the benefits and risks of the SC trastuzumab formulation according to published data.

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PCN39 Potential Time and Cost Savings with Herceptin (Trastuzumab) Subcutaneous (SC) Injection Versus Herceptin Intravenous (IV) Infusion: Results from Three Different English Patient Settings

Cited by 6 publications

References 0 publications

Economic Analysis of Intravenous vs. Subcutaneously Administered Trastuzumab for the Treatment of HER2+ Early Breast Cancer in Malaysia

Economic Analysis of Intravenous vs. Subcutaneously Administered Trastuzumab for the Treatment of HER2+ Early Breast Cancer in Malaysia

Subcutaneous trastuzumab: a review of its use in HER2-positive breast cancer

Development of New Formulations of Biologics: Expectations, Immunogenicity, and Safety for Subcutaneous Trastuzumab

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