Economic Evaluation of the Organizational Impact of Atezolizumab Subcutaneous in a French Hospital

OBJECTIVES: The aim of this evaluation is to estimate the expected organizational impact of atezolizumab in its subcutaneous form (SC) compared to an intravenous (IV) form in the University hospital of Nantes.

METHODS: Outcomes of organizational impact were the following: preparation time by the pharmacy, administration time by the nurses and chair occupancy duration. Capacity gains related to potential savings of chair occupancy duration were valued in terms of earnings for the hospital according to the tariff of the national health insurance.

Results were estimated over a year for a theoretical number of 100 patients initiating a treatment.

Time inputs regarding treatment preparation by the pharmacy were collected for two different methods of preparation, manual and robotic. As atezolizumab SC was not yet reimbursed in France, time of preparation of another SC immunotherapy with the same vial size was used as a proxy.

Time inputs regarding treatment administration were based on the Summary of Product Characteristics (7 minutes for atezolizumab SC and 30 minutes for IV). Additional time of nurse and hospital chair occupancy were collected through healthcare professionals.

RESULTS: Atezolizumab SC could allow saving 38 hours of work in pharmacy if treatments are prepared manually or 55 hours if treatments are prepared with a robot. It could also allow saving 522 hours of work to nurses.

Those time saved allows hospitals to allocate healthcare professional to other medical activities.

Atezolizumab SC introduction could also allow overloaded hospitals to reduce chair occupancy by 1,102 hours over a year. Once reallocated, it could allow the hospital to perform 275 additional chemotherapy sessions for an amount of 126,960 euros.

CONCLUSIONS: Atezolizumab SC treatment could allow time savings for hospitals during the preparation and the administration compared to IV treatments. Those time savings could be allocated to increase the capacity of the hospital to treat more patients.