Comparison of Central Venous Access Device Insertion Proportions, Costs and Removal Time Between Subcutaneous and Intravenous Formulations of Pertuzumab and Trastuzumab in HER2+ Early Breast Cancer Patients
Author(s)
Ibrahim Abbass, RPh, PhD1, Emma Behan, Dr2, Anita Fung, Dr2, Achal Patel, PhD2;
1Genentech, Principal Health Economist, South San Francisco, CA, USA, 2Genentech Inc., South San Francisco, CA, USA
1Genentech, Principal Health Economist, South San Francisco, CA, USA, 2Genentech Inc., South San Francisco, CA, USA
OBJECTIVES: The subcutaneous (SQ) formulation of anticancer drugs may enhance patient experience and quality of life (QoL) by reducing the need for central venous access device (CVAD) insertion. This study compared CVAD insertion proportions, costs, and time to removal between SQ fixed-dose combination [FDC] and intravenous (IV) formulations of Pertuzumab and Trastuzumab (PH) in patients with early breast cancer (eBC).
METHODS: Retrospective analysis was conducted using IQVIA PharMetricsⓇ Plus data (01/01/2021-12/31/2023) for adult women with HER2+ eBC. Patients were categorized into neoadjuvant (NEO) and adjuvant only (ADJ). Targeted maximum likelihood estimation (TMLE) with machine learning was used to estimate differences in CVAD insertion probability, adjusting for age, payer type, plan type, CCI and baseline total cost. Kaplan-Meier analysis estimated mean time to CVAD removal over 12 months.
RESULTS: Among 1,634 patients, 81% were in the NEO cohort (n=1,325) and 19% in the ADJ cohort (n=309). In the NEO cohort , 90% of PH FDC patients required CVAD insertion versus 95% for PH IV with mean times to CVAD removal of 318 days (FDC) vs. 334 days (PHIV). In the ADJ cohort , 74.3% of PH FDC patients required CVAD insertion versus 87.2% of PH IV, with mean times to removal of 300 days (FDC) vs. 342 days (IV). TMLE-estimated CVAD insertion probabilities were 3.5% lower in NEO, and 9.6% lower in ADJ cohorts for PH FDC (p-value <0.001). Average total healthcare costs at the day of CVAD insertion ranged from $7,569 to $10,320, with direct CVAD costs between $3,377 and $4,150.
CONCLUSIONS: PH FDC (SQ) is associated with a lower CVAD insertion proportions, and shorter time to removal compared to PH IV, which may enhance patients' experience, improve their QoL and reduce healthcare costs.
METHODS: Retrospective analysis was conducted using IQVIA PharMetricsⓇ Plus data (01/01/2021-12/31/2023) for adult women with HER2+ eBC. Patients were categorized into neoadjuvant (NEO) and adjuvant only (ADJ). Targeted maximum likelihood estimation (TMLE) with machine learning was used to estimate differences in CVAD insertion probability, adjusting for age, payer type, plan type, CCI and baseline total cost. Kaplan-Meier analysis estimated mean time to CVAD removal over 12 months.
RESULTS: Among 1,634 patients, 81% were in the NEO cohort (n=1,325) and 19% in the ADJ cohort (n=309). In the NEO cohort , 90% of PH FDC patients required CVAD insertion versus 95% for PH IV with mean times to CVAD removal of 318 days (FDC) vs. 334 days (PHIV). In the ADJ cohort , 74.3% of PH FDC patients required CVAD insertion versus 87.2% of PH IV, with mean times to removal of 300 days (FDC) vs. 342 days (IV). TMLE-estimated CVAD insertion probabilities were 3.5% lower in NEO, and 9.6% lower in ADJ cohorts for PH FDC (p-value <0.001). Average total healthcare costs at the day of CVAD insertion ranged from $7,569 to $10,320, with direct CVAD costs between $3,377 and $4,150.
CONCLUSIONS: PH FDC (SQ) is associated with a lower CVAD insertion proportions, and shorter time to removal compared to PH IV, which may enhance patients' experience, improve their QoL and reduce healthcare costs.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
CO62
Topic
Clinical Outcomes
Topic Subcategory
Clinical Outcomes Assessment
Disease
SDC: Oncology