The Budget Impact and Time Savings of Introducing Subcutaneously Administered Nivolumab and Hyaluronidase (NIVO SC) to Patients Receiving Intravenously Administered Nivolumab (NIVO IV) Across Indications in Canada
Author(s)
Dimitrios Tomaras, MSc1, Victor Genestier, MSc2, Karishma Shelley, MS, PharmD3.
1Bristol Myers Squibb, Montreal, QC, Canada, 2Amaris Consulting, Toronto, ON, Canada, 3Bristol Myers Squibb, Princeton, NJ, USA.
1Bristol Myers Squibb, Montreal, QC, Canada, 2Amaris Consulting, Toronto, ON, Canada, 3Bristol Myers Squibb, Princeton, NJ, USA.
Presentation Documents
OBJECTIVES: NIVO SC provides an alternative mode of administration compared to NIVO IV. The Checkmate 67T trial compared NIVO SC to NIVO IV and met pharmacokinetic and non-inferiority endpoints. This budget impact analysis’ (BIA) objective was to quantify the financial impact, and the effect on select healthcare resource utilization (HCRU), of reimbursing NIVO SC from a Canadian drug plan perspective.
METHODS: A BIA assessed the impact of switching NIVO IV patients to NIVO SC over 3 years across Canada. The BIA included drug acquisition costs, as well as exploratory analyses on chair time differences and healthcare practitioner (HCP) time savings related to drug preparation, administration & monitoring. Epidemiology and HCRU inputs were sourced from the literature. The dosing schedules of NIVO IV & NIVO SC were based on their respective Health Canada-approved product monographs. NIVO IV includes flat dosing, but not weight-based options, across all relevant indications, however, a weight-based NIVO IV dosing approach was explored in a sensitivity scenario.
RESULTS: A total of 4,414 patients were estimated to receive NIVO SC in Canada across 3 years with 36% of eligible NIVO IV patients having switched to SC by year 3. This resulted in an incremental budget impact of -$50,718,198. Additionally, an estimated 30,363 hours of chair time would be saved as well as 63,650 HCP hours according to exploratory analyses. The weight-based NIVO IV dosing sensitivity scenario also demonstrated that the adoption of NIVO SC consistently results in drug cost savings.
CONCLUSIONS: The adoption of NIVO SC would drive significant savings to the payer’s drug budget, while simultaneously improving chair time & healthcare resource efficiencies to ease burden in a strained healthcare system, especially considering the large patient volume. Moreover, in previous patient preference studies, patients preferred SC to IV administration. Additional real-world studies would further validate these findings.
METHODS: A BIA assessed the impact of switching NIVO IV patients to NIVO SC over 3 years across Canada. The BIA included drug acquisition costs, as well as exploratory analyses on chair time differences and healthcare practitioner (HCP) time savings related to drug preparation, administration & monitoring. Epidemiology and HCRU inputs were sourced from the literature. The dosing schedules of NIVO IV & NIVO SC were based on their respective Health Canada-approved product monographs. NIVO IV includes flat dosing, but not weight-based options, across all relevant indications, however, a weight-based NIVO IV dosing approach was explored in a sensitivity scenario.
RESULTS: A total of 4,414 patients were estimated to receive NIVO SC in Canada across 3 years with 36% of eligible NIVO IV patients having switched to SC by year 3. This resulted in an incremental budget impact of -$50,718,198. Additionally, an estimated 30,363 hours of chair time would be saved as well as 63,650 HCP hours according to exploratory analyses. The weight-based NIVO IV dosing sensitivity scenario also demonstrated that the adoption of NIVO SC consistently results in drug cost savings.
CONCLUSIONS: The adoption of NIVO SC would drive significant savings to the payer’s drug budget, while simultaneously improving chair time & healthcare resource efficiencies to ease burden in a strained healthcare system, especially considering the large patient volume. Moreover, in previous patient preference studies, patients preferred SC to IV administration. Additional real-world studies would further validate these findings.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE687
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Health Technology Assessment
Topic Subcategory
Budget Impact Analysis
Disease
Biologics & Biosimilars, Oncology