CAPACITY VALUE AND ACQUISITION PREMIUM IN IV-TO-SC DARATUMUMAB SWITCHING: A UAE COST-CONSEQUENCE ANALYSIS AT SSMC A TERTIARY ONCOLOGY CENTER IN MIDDLE EAST
Author(s)
Ammar Abdaljalil, BSc Pharm BCOP PgDip HTA1, Rayan Elamin, MSc, EMBA, CPHQ1, Ameera El Gendy, BSc Pharm BCPS1, Ghulam Mustafa, PharmD1, Lamia Yahya, BSc Pharm BCPS BCNSP1, Marleine Bejjani, PharmD1, Moussab Damlaj, MD FRCPC FACP2, Husni Al hateeti, MD, MSc, MRCP2, Fatema Al Shehhi, MD2, Waed Jaber, MBBS2, Aydah Alawadhi, MD2.
1Pharmacy, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates, 2Oncology/Hematology, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
1Pharmacy, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates, 2Oncology/Hematology, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
OBJECTIVES: To quantify, from a UAE tertiary oncology centre (SSMC) perspective at DOH pharmacy-acquisition prices, the net monetary impact of switching IV visits to flat-dose SC 1,800 mg, across payer, provider and societal perspectives, with an adverse-event (AE)-avoidance credit.
METHODS: Retrospective microcosting of SSMC records identified 214 IV-base visits (238 rows; outliers over 720 min excluded) across 23 patient sequences, each modeled as a single 60-minute SC administration. Drug, staff, patient-time and freed-capacity resources were valued at AWP/operational unit costs, aggregated by perspective. A released-capacity opportunity (full pathway-time delta, 100% backfill) and AE-avoidance credit were included. A 1,000-iteration probabilistic sensitivity analysis (PSA) and patient-weight scenario were run. Outcomes in AED and PPP international dollars (Int$).
RESULTS: Switching raised drug acquisition by AED 1,018,820/Int$ 437,199, the dominant driver. Net impacts were payer AED (1,018,820)/Int$ (437,199), provider AED (580,241)/Int$ (248,995), and societal AED (538,900)/Int$ (231,254); the AE-avoidance credit (AED 25,668/Int$ 11,015). PSA mean was AED (541,305)/Int$ (232,286) (95% CI (795,980) to (296,967)/Int$ (341,573) to (127,435)), entirely negative. Secondary weight analysis: because IV is weight-dosed while SC is flat, SC becomes drug-cost-neutral at ~82 kg and societally net-favorable from ~76 kg. The deficit reflects a weight-light cohort (mean 68 kg); a weight-stratified switch (SC if 76+ kg) turns the cohort societal result positive (+AED 274,122/Int$ +117,632), and a heavier cohort (mean 85 kg) is net-saving (PSA mean +AED 748,721/Int$ +321,293; 95% CrI from +AED 102,657/Int$ +44,052).
CONCLUSIONS: In this single-centre UAE analysis, SC reduced chair, staff and patient time but was not cost-neutral under AWP: the acquisition premium exceeded offsets, a local signal, not a universal formulary conclusion. The base case reflects a weight-light cohort (mean 68 kg) and reverses in heavier populations, so body-weight distribution is a co-equal cost driver alongside AWP. Findings support P&T assessment with site-specific inputs.
METHODS: Retrospective microcosting of SSMC records identified 214 IV-base visits (238 rows; outliers over 720 min excluded) across 23 patient sequences, each modeled as a single 60-minute SC administration. Drug, staff, patient-time and freed-capacity resources were valued at AWP/operational unit costs, aggregated by perspective. A released-capacity opportunity (full pathway-time delta, 100% backfill) and AE-avoidance credit were included. A 1,000-iteration probabilistic sensitivity analysis (PSA) and patient-weight scenario were run. Outcomes in AED and PPP international dollars (Int$).
RESULTS: Switching raised drug acquisition by AED 1,018,820/Int$ 437,199, the dominant driver. Net impacts were payer AED (1,018,820)/Int$ (437,199), provider AED (580,241)/Int$ (248,995), and societal AED (538,900)/Int$ (231,254); the AE-avoidance credit (AED 25,668/Int$ 11,015). PSA mean was AED (541,305)/Int$ (232,286) (95% CI (795,980) to (296,967)/Int$ (341,573) to (127,435)), entirely negative. Secondary weight analysis: because IV is weight-dosed while SC is flat, SC becomes drug-cost-neutral at ~82 kg and societally net-favorable from ~76 kg. The deficit reflects a weight-light cohort (mean 68 kg); a weight-stratified switch (SC if 76+ kg) turns the cohort societal result positive (+AED 274,122/Int$ +117,632), and a heavier cohort (mean 85 kg) is net-saving (PSA mean +AED 748,721/Int$ +321,293; 95% CrI from +AED 102,657/Int$ +44,052).
CONCLUSIONS: In this single-centre UAE analysis, SC reduced chair, staff and patient time but was not cost-neutral under AWP: the acquisition premium exceeded offsets, a local signal, not a universal formulary conclusion. The base case reflects a weight-light cohort (mean 68 kg) and reverses in heavier populations, so body-weight distribution is a co-equal cost driver alongside AWP. Findings support P&T assessment with site-specific inputs.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
HTA91
Topic
Economic Evaluation, Health Service Delivery & Process of Care, Health Technology Assessment
Disease
Oncology