A Systematic Literature Review of Economic Burden and Medication Adherence With Subcutaneous Versus Intravenous Oncology Therapies

Speaker(s)

Casañas i Comabella C1, Burnett H2, Nguyen V3, Sarocco P4, Epstein RS5
1Evidera, Oxford, UK, 2Evidera, Bethesda, MD, USA, 3Evidera, Ivry-sur-Seine Cedex, France, 4Halozyme Therapeutics, Inc., San Diego, CA, USA, 5Epstein Health, LLC, Woodcliff Lake, NJ, USA

Presentation Documents

OBJECTIVES: While subcutaneous (SC) delivery offers some benefits over intravenous (IV) administration, SC administration is underutilized in the USA. It was therefore relevant to summarize the impact of SC versus IV administration of anti-cancer therapies on healthcare resource use (HCRU), costs, and adherence. This study aimed to comprehensively identify recent scientific publications assessing the impact of SC versus IV administration of anti-cancer therapies.

METHODS: Searches were conducted in Embase, Medline, EconLit, and PsycINFO. Observational studies published 2014-2024 were included. Publications were screened by 2 independent reviewers. Data were extracted by 1 reviewer and validated by a second.

RESULTS: Of 3296 publications screened, 21 were included (16 Europe; 3 USA; 2 multinational). Most were on hematological (n=10) and breast (n=9) cancer. All treatments were administered by healthcare professionals (HCPs) and included trastuzumab (n=9), rituximab (n=7), daratumumab (n=3), and trastuzumab+rituximab (n=2).

Thirteen studies reported costs (0 USA), and all showed cost savings with SC versus IV administration in drug costs, consumable supplies, chair time, HCP time, cost per cycle, and overall. HCRU was reported in 20 studies (3 USA); all demonstrated savings in HCP working time, pre- and post-infusion chair time, pharmacy time, patient time, and length of in- and out-patient stay. No studies were identified comparing SC and IV adherence in the USA.

CONCLUSIONS: This systematic literature review (SLR) demonstrates tangible savings in HCRU and costs with SC versus IV administration. Most US SC studies focused on comparative safety and efficacy, to be expected with any new technology’s early adoption phase. In contrast, nearly all published economic evidence was from European countries, demonstrating a need for US-based studies comparing costs, HCRU, and medication adherence between SC and IV routes. Findings from this SLR may be useful for policy and healthcare decision-making in the USA where SC administration is currently underutilized.

Code

EE31

Topic

Economic Evaluation

Topic Subcategory

Cost-comparison, Effectiveness, Utility, Benefit Analysis, Work & Home Productivity - Indirect Costs

Disease

No Additional Disease & Conditions/Specialized Treatment Areas, Oncology