Switching from Intravenous to Subcutaneous Rituximab Saves Staff Time and Money

March 2014, Vol 5, No 2

New Orleans, LA—The efficiency of rituximab (Rituxan) and the associated cost can be improved by switching from intravenous (IV) to subcutaneous (SC) administration. Such a switch led to a substantial reduction in patient chair time and in active healthcare professional time, said Christof Wiesner, PhD, MPH, of the Market Access Department, Genentech, San Francisco, CA, at the ASH 2013 meeting.

Rituximab is the standard treatment for indolent non-Hodgkin lymphoma and is currently administered by IV infusion. Results from studies of follicular lymphoma showed that a fixed-dose SC formulation of rituximab shortened administration time, without compromising the drug’s efficacy or safety.

Dr Wiesner and colleagues conducted a multinational, prospective, observational study to assess the possible resource benefits of switching from IV rituximab to SC administration. The data for rituximab SC injections were collected alongside a phase 3b trial, whereas the data for IV rituximab infusions were collected in a real-world setting in 23 international centers.

“We found time-savings from the patient’s perspective in the range of 50% to 80%, which is pretty impressive, but we also have savings in the active healthcare professional time…pharmacists and nurses, in the range of 40% going up to 50%,” said Dr Wiesner.

The difference in the mean active healthcare professional time saved by switching from IV rituximab to SC ri­tuximab ranged from 7.3 minutes (Austria) to 30.9 minutes (United Kingdom). The proportionate reduction in mean healthcare professional time ranged from 28% (Spain) to 59% (Russia).

The mean time saved in the treatment room ranged from 28% to 59%. Over the course of the first year of treatment (8 induction and 3 maintenance sessions), the estimated reduction in total healthcare professional time associated with the switch from IV to SC rituximab ranged from 1.2 hours in Austria to 5.1 hours in the United Kingdom.

The estimated chair time saved per patient for the first year of treatment ranged from a low of 31 minutes to a high of 60 minutes.

The estimated healthcare professional cost-savings per patient in the first year of treatment ranged from 25% in Spain to 52% in Russia. The healthcare professional opportunity cost-savings were driven mainly by a reduction in pharmacy staff time in Spain and in the United Kingdom, and by a reduction in physician and nurse time in other countries.

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