SUBCUTANEOUS TRASTUZUMAB UPTAKE IN FRANCE: A NATIONWIDE REAL-WORLD ANALYSIS OF INDICATION, SETTING, AND REGIONAL PRACTICE PATTERNS - BI-FORM STUDY
Author(s)
Olivier Tredan, PhD1, Nicolas GIRARD, PhD2, HERVE LEMASSON, Sr., MA3, veronique MOREAU MALLET, PhD3, Camille Nevoret, PhD4, Alicia Fravalo, MA4, Morgane Pierre, MS5.
1Centre de Lutte Contre le Cancer, Léon Bérard, Lyon, France, 2Hôpital Institut Curie, Paris, France, 3Bristol Myers Squibb, RUEIL MALMAISON, France, 4CEMKA, Bourg-la-reine, France, 5Public Health Senior Manager, Bristol Myers Squibb, Rueil-Malmaison, France.
1Centre de Lutte Contre le Cancer, Léon Bérard, Lyon, France, 2Hôpital Institut Curie, Paris, France, 3Bristol Myers Squibb, RUEIL MALMAISON, France, 4CEMKA, Bourg-la-reine, France, 5Public Health Senior Manager, Bristol Myers Squibb, Rueil-Malmaison, France.
OBJECTIVES: Although an increasing number of oncology therapies are available in intravenous (IV) and subcutaneous (SC) formulations, their impact on real-world care pathways remains poorly documented. To better understand SC injection dynamics in oncology, trastuzumab, available in both forms for early and metastatic breast cancer, was used to analyze the SC uptake over time and across regions in France.
METHODS: A retrospective cohort was built using the French national hospital discharge databases. All stays in medicine, surgery, obstetrics or home hospitalization settings between 01/01/2015 and 12/31/2024, with trastuzumab administrations were included. Annual SC use was described from 2015 to 2024 and stratified by breast cancer indication (2019-2024: metastatic monotherapy, metastatic with IV therapy, metastatic with non-IV therapy or early) and center status (university, other public, private non-profit, private). Geographic variations were analyzed.
RESULTS: From 2015 to 2024, 2,308,752 trastuzumab administrations were identified, involving 192,498 patients. Overall, SC use accounted for 51.7% of administrations, decreased from 54.8% (2015-2019) to 47.3% (2019-2023), then increased to 52.1% (2023-2024). The IV-SC trend reversed in 2019 and 2023. SC use was lower and dependent on concomitant treatment among metastatic patients (29.0% of administrations with another IV treatment, 61.7% with oral/SC, 53.9% in monotherapy); in early breast cancer, it reached 65.5%. SC use was higher in public and private hospitals whichever the indication.In 2024, SC uptake varied across regions despite similar indication case-mix and healthcare supply: Bourgogne-Franche-Comté and Île-de-France showed similar proportion of administrations for early breast cancer (~80%) and a broadly comparable center-status distributions, yet SC use differed markedly (74.1% vs 51.4%).
CONCLUSIONS: SC trastuzumab use remained stable overall but showed significant annual and regional variation. Beyond indication and care supply, local practices or institutional policies and broader contextual changes such as the COVID-19 pandemic or expansion of hospital-at-home care may have influenced SC utilization.
METHODS: A retrospective cohort was built using the French national hospital discharge databases. All stays in medicine, surgery, obstetrics or home hospitalization settings between 01/01/2015 and 12/31/2024, with trastuzumab administrations were included. Annual SC use was described from 2015 to 2024 and stratified by breast cancer indication (2019-2024: metastatic monotherapy, metastatic with IV therapy, metastatic with non-IV therapy or early) and center status (university, other public, private non-profit, private). Geographic variations were analyzed.
RESULTS: From 2015 to 2024, 2,308,752 trastuzumab administrations were identified, involving 192,498 patients. Overall, SC use accounted for 51.7% of administrations, decreased from 54.8% (2015-2019) to 47.3% (2019-2023), then increased to 52.1% (2023-2024). The IV-SC trend reversed in 2019 and 2023. SC use was lower and dependent on concomitant treatment among metastatic patients (29.0% of administrations with another IV treatment, 61.7% with oral/SC, 53.9% in monotherapy); in early breast cancer, it reached 65.5%. SC use was higher in public and private hospitals whichever the indication.In 2024, SC uptake varied across regions despite similar indication case-mix and healthcare supply: Bourgogne-Franche-Comté and Île-de-France showed similar proportion of administrations for early breast cancer (~80%) and a broadly comparable center-status distributions, yet SC use differed markedly (74.1% vs 51.4%).
CONCLUSIONS: SC trastuzumab use remained stable overall but showed significant annual and regional variation. Beyond indication and care supply, local practices or institutional policies and broader contextual changes such as the COVID-19 pandemic or expansion of hospital-at-home care may have influenced SC utilization.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
OP4
Topic
Health Service Delivery & Process of Care, Organizational Practices, Real World Data & Information Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Oncology