Operational and Economic Impact of CLL Treatment Regimens: Insights From a Multidisciplinary Study in Portugal
Author(s)
Patrícia Redondo, MSc1, Tomás Oliveira, MSc1, Joana Sousa, MSc2, Catarina Moreira, MD3, Florbela Braga, PhD3, Rute Varela, MSc4, Liliana Barbosa, BSc5, Marlene Sousa, BSc6, Afonso Monteiro, MSc7.
1MOAI Consulting, Lisboa, Portugal, 2Partner, MOAI Consulting, Lisboa, Portugal, 3IPO Porto, Porto, Portugal, 4ULS Loures-Odivelas, Lisboa, Portugal, 5ULS São João, Porto, Portugal, 6ULS São José, Lisboa, Portugal, 7Johnson & Johnson MedTech, Porto Salvo, Lisboa, Portugal.
1MOAI Consulting, Lisboa, Portugal, 2Partner, MOAI Consulting, Lisboa, Portugal, 3IPO Porto, Porto, Portugal, 4ULS Loures-Odivelas, Lisboa, Portugal, 5ULS São João, Porto, Portugal, 6ULS São José, Lisboa, Portugal, 7Johnson & Johnson MedTech, Porto Salvo, Lisboa, Portugal.
OBJECTIVES: Chronic lymphocytic leukemia (CLL) is a heterogeneous disease with varied therapeutic approaches. While clinical outcomes improved, operational burden and direct medical and non-medical costs for healthcare providers and patients remain underexplored. This study aimed to evaluate logistical and economic impact of different CLL treatments beyond pharmacological expenses.
METHODS: Semi-structured interviews were conducted with two hematologists, two hospital pharmacists and two nurses across four public hospitals. Data collection focused on time and resources (human and consumables) used over a 12-month period. Key elements considered included drug preparation, administration, monitoring, management of adverse events (AEs), logistics related to patient transport and caregiver involvement. A comparative analysis was performed to evaluate the differences between therapeutic regimens: oral, subcutaneous (SC), and intravenous (IV). Results were validated during a multidisciplinary workshop.
RESULTS: Professional workload and associated costs varied by administration route. Nursing time spent per patient annually was 0.5 hours for oral administration, 4.0 hours for SC, and 9.1 hours for IV. Pharmacist time was recorded at 2.0 hours for oral, 3.3 hours for SC, and 6.1 hours for IV. Annual nursing costs per patient were €9 for oral, €106 for SC, and €420 for IV. The pharmaceutical activity costs associated with the oral route were €33 lower than for SC and €193 lower than for IV. Hematologist's workload was similar across all regimens. From a patient perspective, oral therapies resulted in time savings of 7.2 hours per year compared to SC and 32.0 hours vs IV. Overall, oral regimens saved an average of 4.3h and €386 per patient annually compared to SC, and 13.0h and €1,345 compared to IV. Stakeholders highlighted the cumulative operational burden imposed by non-oral regimens on healthcare teams and services.
CONCLUSIONS: Treatment regimens for CLL present notable differences in both operational and economic burden, particularly among various administration routes.
METHODS: Semi-structured interviews were conducted with two hematologists, two hospital pharmacists and two nurses across four public hospitals. Data collection focused on time and resources (human and consumables) used over a 12-month period. Key elements considered included drug preparation, administration, monitoring, management of adverse events (AEs), logistics related to patient transport and caregiver involvement. A comparative analysis was performed to evaluate the differences between therapeutic regimens: oral, subcutaneous (SC), and intravenous (IV). Results were validated during a multidisciplinary workshop.
RESULTS: Professional workload and associated costs varied by administration route. Nursing time spent per patient annually was 0.5 hours for oral administration, 4.0 hours for SC, and 9.1 hours for IV. Pharmacist time was recorded at 2.0 hours for oral, 3.3 hours for SC, and 6.1 hours for IV. Annual nursing costs per patient were €9 for oral, €106 for SC, and €420 for IV. The pharmaceutical activity costs associated with the oral route were €33 lower than for SC and €193 lower than for IV. Hematologist's workload was similar across all regimens. From a patient perspective, oral therapies resulted in time savings of 7.2 hours per year compared to SC and 32.0 hours vs IV. Overall, oral regimens saved an average of 4.3h and €386 per patient annually compared to SC, and 13.0h and €1,345 compared to IV. Stakeholders highlighted the cumulative operational burden imposed by non-oral regimens on healthcare teams and services.
CONCLUSIONS: Treatment regimens for CLL present notable differences in both operational and economic burden, particularly among various administration routes.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE596
Topic
Economic Evaluation, Health Service Delivery & Process of Care
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Oncology