OBJECTIVES: Breast cancer is the most prevalent cancer in Egypt among women (146.1 per 100,000,IARC,2018).Trastuzumab-based therapies is the standard of care for HER2-+ve breast cancer patients. According to HannaH trial, subcutaneous Trastuzumab (s.c-T) was found to be non-inferior to intravenous Trastuzumab (i.v-T) with a similar safety profile. Besides, PrefHER trial confirmed that s.c-T is preferred by patients and clinicians. The objective of this study was to economically compare s.c-T (Herceptin Hylecta™) versus i.v-T (Herceptin^®) at Nasr City Cancer Center (NCCC), Cairo, Egypt, 2019.

METHODS: A budget impact analysis was conducted for comparing therapy with either drug for HER2-+ve breast cancer patients. Unlike i.v-T, the dosing regimen for s.c-T is weight independent (one vial /3-week).The dose of i.v-T is LD 8 mg/kg then MD 6 mg/kg every three weeks and it was calculated using usual weight (75 Kg).Total costs were calculated for the duration of therapy (54 weeks) for each drug. Besides, the cost savings per patient were estimated. The number of patients predicted to be treated with either drug in 2019 was 100 patients. The number of extra patients that could be managed utilizing cost savings was also estimated. Only direct drug prices were included and expressed in Egyptian Pound (EGP).

RESULTS: For the planned duration of therapy, the approximately calculated total doses per patient were 8700 mg and 18 vials for i.v-T and s.c-T, respectively. Besides, the total estimated costs for i.v-T and s.c-T were 226,299 and 205,200 EGP, respectively. The cost savings per patient were 21,099 EGP per year. For the proposed 100 patients, the cost savings were estimated to be 2,109,900 EGP that could be utilized for managing extra 10 patients using s.c-T.

CONCLUSIONS: Switching from intravenous Trastuzumab (Herceptin^®) to subcutaneous Trastuzumab (Herceptin Hylecta™) has a positive impact on the budget as it is more superior in terms of cost savings.