ASSESSING THE IMPACT ON STAFF RESOURCES AND PATIENT WAITING TIME OF A SWITCH FROM IV TO ORAL CHEMOTHERAPY WITH VINORELBINE
Author(s)
Giorgio Lorenzo Colombo, MSc, Research Director1, Mauro Caruggi, MSc, Professor2, Chiara Ottolini, MSc, researcher3, Diego Cortinovis, MD, Oncologist41S.A.V.E. Studi Analisi Valutazioni Economiche, Milano, Milano, Italy; 2 Università dell'Insubria, Varese, Italy; 3 Azienda Ospedaliera di Busto Arsizio, Varese, Busto Arsizio, Varese, Italy; 4 Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italy
OBJECTIVES: Navelbine® (Vinorelbine) Oral is an orally administered formulation of chemotherapy (CT) recently introduced in Italy in the treatment of NSCLC (Non Small Cell Lung Cancer) and Metastatic Breast Cancer. The purpose of this study is to evaluate the economic consequences of the impact on pharmacy, nursing time and patient waiting time of a switch from IV to oral CT in the treatment of NSCLC. METHODS: Cost-minimisation analysis was developed in order to evaluate the times required to deliver IV vinorelbine and oral vinorelbine. The comparison was made in two settings with different patient pathways, in the Cancer Center Unit of Istituto Nazionale dei Tumori, Milan and Azienda Ospedaliera di Busto Arsizio, Varese. A stopwatch was used to time elements of essential processes (pharmacy preparation and chemotherapy administration) and patient waiting time for the delivery of a single dose of chemotherapy, in order to build an hypothetic diagnostic and therapeutic pathway and to describe different phases, times and costs for each formulation. RESULTS: Administration of Vinorelbine Oral was less time consuming in both Cancer Centres. In the base case scenario, total costs were € 171.75 for Oral Vinorelbine (60 mg/m²) versus € 214.84 for IV Vinorelbine (25 mg/m²); for Oral Vinorelbine (80 mg/m²) versus IV Vinorelbine (30 mg/m²) costs were € 240.46 and € 232.82 respectively. Productivity loss and patient waiting time were key drivers to our cost minimisation analysis. Results were submitted to a Sensitivity Analysis. CONCLUSION: Delivery of oral CT is less resource intensive and time consuming than IV CT and reduces overall patient waiting in hospital. A switch from Vinorelbine IV to Oral formulation with home administration could increase the capacity of the Day-Hospital Unit, the number of prescriptions prepared by pharmacy and thereafter a reduction of the patient waiting list wich is associated with a global cost reduction.
Conference/Value in Health Info
2007-10, ISPOR Europe 2007, Dublin, Ireland
Value in Health, Vol. 10, No. 6 (November/December 2007)
Code
PCN35
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Oncology