In a recent publication in the journal The Breast, researchers sought to assess the usage of trastuzumab biosimilars compared with the trastuzumab reference product for the treatment of breast cancer in a hospital setting from a medico-economic point of view, taking into consideration certain factors such as time-savings and patients’ preferences for SC trastuzumab.

The authors wrote, “The arrival of biosimilars has probably changed the cost/effectiveness ratio of IV trastuzumab compared to SC trastuzumab but has made no difference in time savings or patients’ preferences for SC trastuzumab. Therefore, we wondered what the optimal use of trastuzumab would be. We hypothesized that optimizing the prescription of SC trastuzumab would allow a better management of trastuzumab biosimilars in day [outpatient] hospitals.”

The researchers conducted two simulations and conducted a cost-benefit analysis based on the simulations over a time frame of 1 year. The two simulations evaluated included Simulation 1: utilization of IV trastuzumab biosimilar to replace IV and SC reference trastuzumab and Simulation 2: use of SC reference trastuzumab to replace IV reference trastuzumab.

The study assessed data from 544 patients with human epidermal growth factor receptor 2–positive breast cancer in Normandy, France. The cost of hospital stay was established on the cost of consumables related to the route of trastuzumab administration (SC vs. IV), the time patients spent with healthcare professionals, and the type of chemotherapy administered to patients receiving trastuzumab.

With regard to their findings, the authors wrote, “In Simulation 1, there was an average cost-saving of €12 per patient per year, but it resulted in a loss of 10,140 minutes, equivalent to 10 minutes per patient per year when compared to the current situation. Simulation 2 yielded average cost-savings for the hospital amounting to €51 per patient per year, along with a timesaving of 67 minutes per patient per year compared to the current situation.”

The authors indicated that the optimized utilization of trastuzumab IV/SC increases the percentage of biosimilar usage by 150%, and the data obtained from the sensitivity analyses exhibit strong results.

The authors also noted that delivering trastuzumab via the SC route offers the benefit of a short time of administration, a reduction in the time spent by healthcare professionals, and the duration of stay of patients in outpatient hospital.

The authors also wrote, “Our study is therefore in line with their economic logic, showing that optimizing the prescription of trastuzumab would allow the optimization of hospital costs, even if all patients on monotherapy were managed at home rather than in a day hospital. Our study is thus the first to produce an estimate of time savings in a day hospital, thanks to the administration of subcutaneous chemotherapy in home hospitalization.”

The authors concluded that developing a program that fosters the optimizations of using trastuzumab can deliver meaningful cost savings to hospitals while enhancing the quality of service provided to the patients.

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