Presentation (CTI)

OBJECTIVES: Intravenous (IV) trastuzumab (T) and pertuzumab (P) have significantly improved outcomes in HER2-positive early breast cancer. Recent trials have explored the combined subcutaneous (SC) formulation showing similar efficacy and safety outcomes. However, the cost and resource incurred remain underexplored. This study aimed to assess the monetary outcomes of SC versus IV T/P in early breast cancer patients at the National Center for Cancer Care and Research (NCCCR).
METHODS: A cost-minimization analysis model was conducted over a 5-year horizon, where direct costs included cost of medication, administration, management of adverse drug events (ADEs), and Day Care admissions. The costs of consumables were determined by using unit costs of resources and consumable from the hospital perspective. The model included two scenarios: the current scenario in which 100% of patients received T/P IV infusion and the proposed scenario in which 100% of patients received T/P SC formulation. Overall costs of both scenarios were calculated and compared to estimate cost differences. One-way sensitivity analysis was conducted.
RESULTS: The 5-year cost of treatment with T\P SC was QAR 384,234,191, compared to QAR 401,049,105 with T\P IV, resulting in a total cost saving of QAR 16,814,915 in favor of the SC regimen. While the SC formulation incurred slightly higher treatment and adverse event management costs, it significantly reduced administration costs from QAR 124 million to QAR 55 million. Switching from IV to SC administration resulted in a saving of approximately QAR 11,942 per patient over 5 years. The primary driver of cost savings was the reduction in drug administration costs and healthcare provider (HCP) costs associated with the SC formulation.
CONCLUSIONS: Over a five-year period, switching from IV to SC T/P offers notable cost savings, primarily due to reduced administration and HCP costs. These findings support the adoption of T\P SC formulation in NCCCR.