TITLE:
Cost-Minimization and Budget Impact Analysis of Rituximab SC VS Rituximab IV for Non-Hodgkin’s Lymphoma (NHLs) in Greece
AUTHORS:
Dionysis Kyriopoulos, Vasiliki Tsiantou, Labrini Papageorgiou, Fani Theodoropoulou, Kostas Athanasakis
KEYWORDS:
Non-Hodgkin’s Lymphoma, Intravenous, Subcutaneous, Nursing Time, Chair Time, Greece
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.8 No.8,
August
3,
2017
ABSTRACT: Background: Non-Hodgkin’s lymphoma (NHLs) is a prevalent type of cancer
for which Intravenous (IV) Rituximab is a widely used treatment option.
Nevertheless, IV infusions can lead to intense resource use and, subsequently,
costs. Given that a subcutaneous (SC) therapeutically equivalent formulation
of the drug is currently available, this study aimed to examine the potential
clinical and economic value of the introduction of the SC formulation for the
Greek healthcare setting. Methods: A cost-minimization and budget-impact
analysis contributed to comparing staff, patient time and resource utilization
and estimating the clinical effects and associated costs in the IV and SC administration.
A questionnaire-based survey was used to provide data regarding
the local treatment patterns and the resource use associated with each
treatment in the Greek NHS. The analysis followed the third-party payer
perspective, and cost data relevant to personnel salaries, pharmaceuticals and
resource utilization were obtained from official government sources. Results:
SC administration was associated with time savings in activities such as
pre-medication administration (3 minutes saved with the SC use), monitoring
during infusion (12 minutes for physicians and 3 minutes for nurses) as well
as time-savings in the preparation of the drugs, the actual dispensing process
and the post-injecting monitoring processes. A significant decrease was observed
in the nursing and chair time (57% and 90% per case, respectively) and
a higher level of services could be secured in terms of hospital capacity with
the SC use. SC administration was found to generate budget savings of
618,708€ per 1000 patients/3 years over the full course of treatment. Conclusions:
Switching IV to SC administration, as demonstrated in the case of Rituximab
for NHLs in Greece, can reduce staff time and administration costs,
improve the capacity of the system and, possibly, improve resource allocation
in the healthcare system.