OPTIMIZING CANCER CARE DELIVERY IN ARGENTINA: INSTITUTIONAL BUDGET AND CAPACITY IMPACT OF SUBCUTANEOUS PEMBROLIZUMAB
Author(s)
Lucas Perelli, MD1, Shalini Kumari, .2, Ying Xiao, .3, Federico Lipszyc, MBA4, Raquel Aguiar-Ibáñez, BS, MSc5.
1MSD ARGENTINA S.R.L., buenos aires, Argentina, 2Merck & Co., Inc., Rahway, NJ, USA, NJ, PA, USA, 3MSD, London, United Kingdom, 4MSD, Buenos Aires, Argentina, 5Merck Canada, Toronto, ON, Canada.
1MSD ARGENTINA S.R.L., buenos aires, Argentina, 2Merck & Co., Inc., Rahway, NJ, USA, NJ, PA, USA, 3MSD, London, United Kingdom, 4MSD, Buenos Aires, Argentina, 5Merck Canada, Toronto, ON, Canada.
OBJECTIVES: To estimate the institutional budgetary and operational impact of introducing subcutaneous (SC) as an alternative to intravenous (IV) pembrolizumab in Argentina.
METHODS: A 3-year institutional budget impact model compared a reference scenario (IV pembrolizumab only) with a new scenario including gradual uptake of SC pembrolizumab (5%, 22% and 30% in years 1, 2 and 3, respectively) across eligible patients. The model assumed 1,000 pembrolizumab administrations annually, with price parity per administration between SC and IV formulations. Outcomes included administration-related costs, healthcare professional time, consumable use, chair and treatment room time, institutional capacity, and work-related indirect costs. Time and resource-use inputs were primarily informed by a multicountry observational study; Argentine sources were used for local cost and productivity inputs. Deterministic one-way sensitivity and scenario analyses were performed.
RESULTS: Over 3 years, SC adoption reduced administration-related costs from USD $61,397 to $51,879, yielding savings of $9,518 (−15.5%) at an institutional level. These savings were driven by reductions in healthcare professional resource-use costs (−US$1,167) and consumable costs (−$8,351). Active healthcare professional time decreased by 112 hours (−8.7%) in total, and by 11.8 minutes (45.6%) per administration, while the cost of care per administration decreased by approximately $17 (−81.6%). From the patient-centered perspective, chair time and treatment room time decreased by 553 and 571 hours, respectively, corresponding to an estimated additional capacity of 32 patients or 562 SC administrations over the time horizon. Work-related indirect costs decreased by 28% per administration and by 5% at an institutional level. Time horizon, uptake, and consumable costs were key drivers in sensitivity analyses.
CONCLUSIONS: In this institutional model, the economic impact of SC pembrolizumab was mainly driven by lower administration-related costs. Adoption of the SC formulation may improve operational efficiency and institutional capacity, while reducing healthcare professional time, time burden on patients and indirect costs.
METHODS: A 3-year institutional budget impact model compared a reference scenario (IV pembrolizumab only) with a new scenario including gradual uptake of SC pembrolizumab (5%, 22% and 30% in years 1, 2 and 3, respectively) across eligible patients. The model assumed 1,000 pembrolizumab administrations annually, with price parity per administration between SC and IV formulations. Outcomes included administration-related costs, healthcare professional time, consumable use, chair and treatment room time, institutional capacity, and work-related indirect costs. Time and resource-use inputs were primarily informed by a multicountry observational study; Argentine sources were used for local cost and productivity inputs. Deterministic one-way sensitivity and scenario analyses were performed.
RESULTS: Over 3 years, SC adoption reduced administration-related costs from USD $61,397 to $51,879, yielding savings of $9,518 (−15.5%) at an institutional level. These savings were driven by reductions in healthcare professional resource-use costs (−US$1,167) and consumable costs (−$8,351). Active healthcare professional time decreased by 112 hours (−8.7%) in total, and by 11.8 minutes (45.6%) per administration, while the cost of care per administration decreased by approximately $17 (−81.6%). From the patient-centered perspective, chair time and treatment room time decreased by 553 and 571 hours, respectively, corresponding to an estimated additional capacity of 32 patients or 562 SC administrations over the time horizon. Work-related indirect costs decreased by 28% per administration and by 5% at an institutional level. Time horizon, uptake, and consumable costs were key drivers in sensitivity analyses.
CONCLUSIONS: In this institutional model, the economic impact of SC pembrolizumab was mainly driven by lower administration-related costs. Adoption of the SC formulation may improve operational efficiency and institutional capacity, while reducing healthcare professional time, time burden on patients and indirect costs.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE84
Topic
Economic Evaluation, Health Technology Assessment, Medical Technologies
Topic Subcategory
Budget Impact Analysis
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology