26P - Subcutaneous trastuzumab versus intravenous trastuzumab for treatment of patients with HER2-positive breast cancer: A time, motion and cost-benefit assessment in a day care oncology unit in China

Background

Subcutaneous (SC) trastuzumab offers a distinctive approach to treat HER2-positive breast cancer in contrast with conventional intravenous (IV) infusion. SC can be administered at day care unit, which is potentially a big step forward with a more efficient treatment mode compared to IV administration at inpatient wards. This study aimed to quantify the impact of treatment mode transition by measuring its benefits to hospitals as well as patients in China.

Methods

This time-motion study was conducted in Tianjin Medical University Cancer Institute & Hospital, where breast cancer treatment mode was shifted from IV administration at inpatient ward to SC administration at day care unit. The duration of each specific task conducted by HCPs and the time patient spent were recorded by observers. Costs, including HCP salaries, medical consumables, and other relevant items, were collected from public sources. The study outcomes included hospital capacity improvements, time savings for HCPs, and cost reductions for hospital. Meanwhile, patients' time savings and cost of lost labor were also measured.

Results

The treatment mode transition significantly improved the hospital operation efficiency. For 80 patients visited per day, IV administration required 80 inpatient beds, but SC administration in day care unit only occupied 6 injection chairs, equals to a freeing up of around 24,960 bed-days annually for a hospital. Considering this optimized and reallocated inpatient resources, estimated potential benefits were CNY 68,902 per day and CNY 21,497,490 per year. In addition, the adoption of SC administration reduced nursing working hour by 81%. For patients and caregivers, the treatment time per cycle was 91% less than IV administrations, leading to total savings of CNY 19,681 per patient in terms of direct cost and productivity cost over a full course of treatment.

Conclusions

Besides saving time for HCPs and patients, trastuzumab SC can help optimize treatment process, improve overall quality and efficiency of healthcare system & hospital management, aligned with China policies of high-quality hospital development.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Tianjin Medical University Cancer Institute & Hospital.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.