Impact of the change of presentation of the trastuzumab for the Social Security of Costa Rica, cost minimization study
DOI:
https://doi.org/10.51481/amc.v61i1.1023Keywords:
Breast cancer, economic evaluation, trastuzumabAbstract
Objective: Given that at this time is available at the Costa Rican Social security both trastuzumab for intravenous as for subcutaneous administration, and that the presentation for subcutaneous administration has documented to be not inferior to the intravenous. It is relevant to have a study of cost minimization to investigate what formulation is more convenient to maintain in the public health system, based on criteria of efficiency of the intervention.
Methods: A study was developed to evaluate, from the financial perspective of the Social Security of Costa Rica, two different options of application of trastuzumab in patients with breast cancer. The related procedures were identified and documented for the two types treatment application. Both treatment options were based on seventeen dose schemes, with the estimate of supplies and the time of the health professional for each possibility. The analysis also included the evaluation from the patient's perspective.
Results: The economic evaluation of the application procedure for both alternatives evidenced that the subcutaneous option had an application cost of $78.6 and $467.34 for the intravenous option. From the financial perspective the subcutaneous option constitutes the alternative with lower cost, with a cost around $4000.0 by treatment per patient, and from the patient perspective implies a 45.0% less time for session than then intravenous option.
Conclusions: Trastuzumab subcutaneous formulation evidenced a substantial time and cost reduction in comparison with the intravenous formulation in the Costa Rican Social Security System.
Downloads
References
Ginsburg O, Bray F, Coleman MP, Vanderpuye V, Eniu A, Kotha SR, et al. The global burden of women's cancers: a grand challenge in global health. The Lancet 2017;389:847-60. doi:10.1016/S0140-6736(16)31392-7.
Rosenstock AS, Hortobagyi GN. Early-Stage and Locally Advanced Breast Cancer. In: Kantarjian HM, Wolff RA, editors. MD Anderson Man. Med. Oncol. 3e, New York, NY: McGraw-Hill Medical; 2016.
DeSantis CE, Ma J, Goding Sauer A, Newman LA, Jemal A. Breast cancer statistics, 2017, racial disparity in mortality by state: Breast Cancer Statistics, 2017. CA Cancer J Clin 2017. doi:10.3322/caac.21412.
Lippman ME. Breast Cancer. In: Kasper D, Fauci A, Hauser S, Longo D, Jameson JL, Loscalzo J, editors. Harrisons Princ. Intern. Med. 19e, New York, NY: McGraw-Hill Education; 2015.
Nguyen QNT, Nguyen HQ, O'Neill C. A Critical Review of Economic Evaluations of Trastuzumab in the Treatment of Early Stage HER2 Positive Breast Cancer. Pharmacoeconomics n.d.;2.
Ismael G, Hegg R, Muehlbauer S, Heinzmann D, Lum B, Kim S-B, et al. Subcutaneous versus intravenous administration of (neo)adjuvant trastuzumab in patients with HER2-positive, clinical stage I-III breast cancer (HannaH study): a phase 3, open-label, multicentre, randomised trial. Lancet Oncol 2012;13:869-78. doi:10.1016/S1470-2045(12)70329-7.
Jackisch C, Hegg R, Stroyakovskiy D, Ahn J-S, Melichar B, Chen S-C, et al. HannaH phase III randomised study: Association of total pathological complete response with event-free survival in HER2-positive early breast cancer treated with neoadjuvant-adjuvant trastuzumab after 2 years of treatment-free followup. Eur J Cancer 2016;62:62-75. doi:10.1016/j.ejca.2016.03.087.
Pivot X, Verma S, Fallowfield L, Müller V, Lichinitser M, Jenkins V, et al. Efficacy and safety of subcutaneous trastuzumab and intravenous trastuzumab as part of adjuvant therapy for HER2-positive early breast cancer: Final analysis of the randomised, two-cohort PrefHer study. Eur J Cancer 2017;86:82-90. doi:10.1016/j.ejca.2017.08.019.
Pivot X, Gligorov J, Müller V, Barrett-Lee P, Verma S, Knoop A, et al. Preference for subcutaneous or intravenous administration of trastuzumab in patients with HER2-positive early breast cancer (PrefHer): an open-label randomised study. Lancet Oncol 2013;14:962-70. doi:10.1016/S1470-2045(13)70383-8.
Pivot X, Spano JP, Espie M, Cottu P, Jouannaud C, Pottier V, et al. Patients' preference of trastuzumab administration (subcutaneous versus intravenous) in HER2-positive metastatic breast cancer: Results of the randomised MetaspHer study. Eur J Cancer 2017;82:230-6. doi:10.1016/j.ejca.2017.05.009.
Quynh-Nga Thi Nguyen, Hoa Quoc Nguyen, Ciaran O'Neill. A Critical Review of Economic Evaluations of Trastuzumab in the Treatment of Early Stage HER2 Positive Breast Cancer. Pharmacoeconomics n.d.;2:111. doi:10.4172/24721042.1000111.
López-Vivanco G, Salvador J, Diez R, López D, De Salas-Cansado M, Navarro B, et al. Cost minimization analysis of treatment with intravenous or subcutaneous trastuzumab in patients with HER2-positive breast cancer in Spain. Clin Transl Oncol Off Publ Fed Span Oncol Soc Natl Cancer Inst Mex 2017;19:1454-61. doi:10.1007/s12094-017-1684-4.
Tjalma WAA, Van den Mooter T, Mertens T, Bastiaens V, Huizing MT, Papadimitriou K. Subcutaneous trastuzumab (Herceptin) versus intravenous trastuzumab for the treatment of patients with HER2-positive breast cancer: A time, motion and cost assessment study in a lean operating day care oncology unit. Eur J Obstet Gynecol Reprod Biol 2017;221:46-51. doi:10.1016/j. ejogrb.2017.12.006.
Olsen J, Jensen KF, Olesen DS, Knoop A. Costs of subcutaneous and intravenous administration of trastuzumab for patients with HER2-positive breast cancer. J Comp Eff Res 2017. doi:10.2217/cer-2017-0048.
Farolfi A, Silimbani P, Gallegati D, Petracci E, Schirone A, Altini M, et al. Resource utilization and cost saving analysis of subcutaneous versus intravenous trastuzumab in early breast cancer patients. Oncotarget 2017;8:81343-9. doi:10.18632/oncotarget.18527.
Lázaro Cebas A, Cortijo Cascajares S, Pablos Bravo S, Del Puy Goyache Goñi M, González Monterrubio G, Pérez Cárdenas MD, et al. Subcutaneous versus intravenous administration of trastuzumab: preference of HER2+ breast cancer patients and financial impact of its use. J BUON Off J Balk Union Oncol 2017;22:334-9.
Farolfi A, Silimbani P, Gallegati D, Petracci E, Schirone A, Altini M, et al. Resource utilization and cost saving analysis of subcutaneous versus intravenous trastuzumab in early breast cancer patients. Oncotarget 2017;8:81343-9. doi:10.18632/oncotarget.18527.
Downloads
Published
Versions
- 2019-01-14 (2)
- 2019-01-14 (1)
Issue
Section
License
Copyright (c) 2019 Acta Médica Costarricense
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Los autores que publican en la revista Acta Médica Costarricense pueden distribuir, copiar, remezclar, retocar, leer, descargar, imprimir, buscar y crear a partir de su obra de modo no comercial, indicando los créditos a la revista y sus autores y compartir su obra en las mismas condiciones. Para ello se aplica la licencia Creative Commons Reconocimiento-NoComercial-CompartirIgual 4.0 Internacional(CC BY-NC-SA 4.0)
