OBJECTIVES : Bendamustine (BND) treats chronic lymphocytic leukemia (CLL) and indolent, rituximab-refractory B-cell non-Hodgkin lymphoma (iNHL). The budget impact of replacing BND large-volume, long-duration infusion (Belrapzo™; BND-L) formulation with BND small-volume, short-duration infusion (Bendeka^®; BND-S) was analyzed.

METHODS : An illustrative budget impact model (BIM) was developed to estimate facility perspective changes in drug and administration labor costs associated with a hypothetical shift from 50%/50% BND-L/BND-S to exclusive BND-S use. Dosing and per-patient dose count (12 in CLL; 16 in iNHL) were based on product labeling and mean patient body surface area (BSA) of 1.8m². Drug and diluent costs were derived from RED BOOK; administration labor costs were based on US Bureau of Labor Statistics data. Budget impact was estimated for a 10,000-patient facility, with 238 patients receiving BND for CLL or iNHL over one year. Univariate sensitivity analyses were conducted.

RESULTS : Total estimated annual infusion facility incremental savings after utilization shift were $348,579, resulting in $1464.61 savings per-BND-patient-per year (PBPPY). Annual per-patient infusion labor costs per BND-S patient were $75.48 for CLL and $100.64 for INHL; BND-L costs were $226.44 and $603.84, respectively. The model was most sensitive to CLL patient count, BSA, and BND-S treatment cost.

CONCLUSIONS : This BIM estimated annual savings of nearly $350,000 for 238 CLL and iNHL patients in an infusion facility following a utilization shift to 100% BND-S, driven primarily by lower administration labor costs associated with rapid infusion. With comparable drug acquisition costs, facilities see lower labor costs once payers reimburse drug costs. BND-S also provides a clinical advantage over BND-L with option to use 5% dextrose diluent; BND-S admixtures using 5% dextrose are stable at room temperature twice that of BND-L. Labor cost savings will be affected by number of sequential infusions in one day and infusion time reimbursement rates to facilities.