Presentation (CTI)

OBJECTIVES: Subcutaneous administration of monoclonal antibodies in oncology carries several advantages over intravenous alternatives for both the patient and health-system, including decreased drug preparation and administration time, lower healthcare resource use and cost, and improved patient comfort. Our aim was to characterize their annual use trends in the US over a five-year period (2019-2023).
METHODS: We analyzed de-identified data from Trisus Medication Compare (The Craneware Group, Edinburgh, UK) between 1/1/2019-12/31/2023 to identify patient encounters containing a dispensation for subcutaneous formulations of hyaluronidase with rituximab, trastuzumab, daratumumab, and combination pertuzumab and trastuzumab. The primary objective was to characterize annual use trends; secondary objectives included evaluation of use by oncology diagnosis, product, treatment setting, and state.
RESULTS: Dispensations from 47,227 patient encounters were included, with 47,205 for adult patients and only 8 for pediatric patients. The average age was 67.6 years and 53.6% were male. The sample represents 183 health-systems, 57.5% of which are academic medical centers. Almost all use (99.5%) occurred in the outpatient setting. The most common diagnoses were multiple myeloma (75.2%), breast cancer (7.3%), and light-chain amyloidosis (6.5%). Subcutaneous monoclonal antibody use increased annually for the first four years, with peak use in 2022 (n=18,005 dispensations, 38.1%) and lower use in 2023 (n=11,332 dispensations, 24.0%). The most used product was daratumumab with hyaluronidase (82.7% of dispensations), which correlates with the high rate of multiple myeloma in the sample. Rituximab with hyaluronidase accounted for the second most dispensations (10.2%), with associated diagnoses of follicular lymphoma, large B-cell lymphoma, and chronic lymphocytic leukemia. New York (n=8,452 dispensations), Michigan (n=6,132 dispensations), and Massachusetts (n=4,966 dispensations) had the highest use in this sample.
CONCLUSIONS: From 2019-2022, national data show increased use of subcutaneous monoclonal antibodies for oncology, an advantageous alternative offering opportunities to enhance patient care and improve cost and resource efficiency.