Presentation (CTI)

OBJECTIVES: To quantify capacity impact from switching isatuximab intravenous (IV) to subcutaneous (SC) when in combination with bortezomib, lenalidomide, and dexamethasone (IsaVRd) in transplant-ineligible newly diagnosed multiple myeloma patients.
METHODS: Patient volume and administration frequency were sourced from NICE Resource Impact Assessment template ID3981, modelling IsaVRd uptake in England; patient numbers are illustrative projections. Drug administration times were derived from the registrational trial for the subcutaneous formulation. The analysis compares IV vs SC via the manual push and the on-body-injector (OBI). IV administration requires 75 minutes; SC requires 6 minutes; SC OBI requires 13 minutes. Homecare figures are assumed.
RESULTS: Over 5 years, 3,814 patients receive 289,124 total administrations. SC with manual injection saves 69 minutes per dose (332,492 total hours; 87 hours per patient on average over 5 years). SC OBI saves 62 minutes per dose (298,761 total hours; 78 hours per patient) and enables nurses to multitask during the automated administration process. Both SC routes enable homecare delivery per licence. Assuming a conservative 10% homecare uptake, 381 patients and 28,912 administrations shift from hospital settings to home, freeing oncology chair capacity.
CONCLUSIONS: Switching from IV to SC (manual injection or OBI) isatuximab will release approximately 299,000 - 332,000 hours of nursing administration capacity across the eligible NHS England patient population over 5 years. This represents a substantial opportunity to increase oncology throughput, reduce patient chair time, and reallocate skilled nursing resources. Homecare administration further frees hospital capacity while delivering meaningful cost savings. Together, these findings directly support NHS Cancer Plan ambitions, enabling more care to be delivered outside hospitals, improving patient quality of life through reduced hospital visits and treatment burden, while increasing system efficiency, reducing costs, and alleviating staff pressures.