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Comparative Cost Analysis Of Intravenous And Subcutaneous Administration Of Rituximab In Lymphoma Patients

Authors Delgado Sánchez O, Gutiérrez A, do Pazo F, Ginés J, Martorell C, Boyeras B, Bento L, Garcia-Recio M, Sampol A

Received 14 April 2019

Accepted for publication 31 October 2019

Published 18 November 2019 Volume 2019:11 Pages 695—701


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Xing Lin Feng

Olga Delgado Sánchez,1 Antonio Gutiérrez,2 Fernando do Pazo,1 Jordi Ginés,1 Clara Martorell,1 Bàrbara Boyeras,1 Leyre Bento,2 Marta Garcia-Recio,2 Antonia Sampol2

1Pharmacy Department, Son Espases University Hospital, IdISBa, Palma, Spain; 2Lymphoma Unit of Hematology Department, Son Espases University Hospital, IdISBa, Palma, Spain

Correspondence: Olga Delgado Sánchez
Pharmacy Department, Son Espases University Hospital, Ctra. Valldemossa, 79 07120, Palma, Illes Balears, Spain
Tel +34-871 205 187

Purpose: The availability of different routes of administration of rituximab, with different dosing and times of infusion in the day care unit, raises the question of which formulation would be the best in terms of direct cost, particularly with the approval of new intravenous (IV) rituximab biosimilars. We aim to retrospectively compare the direct costs of IV and subcutaneous (SC) rituximab in lymphoma, considering drug cost, pharmacy handling and occupation in day care unit in Son Espases University Hospital during 2017, now that the IV biosimilar is available.
Patients and methods: The data were collected from Oncosafety®-AVIDA for doses and SAP® for economic data. The costs of occupation are published by the Local Health Service.
Results: In 2017, 527 cycles were prescribed for 103 patients with lymphoma: 141 IV and 386 SC. Median doses were 690 mg and 1400 mg with a median cost of the drug of 1458.45€ and 1334.77€ for IV and SC routes, respectively. The nurse handling costs were 4.49€ and 2.24€, respectively. The cost of the day care unit occupation was 493€ and 123€, respectively. Overall, the median total cost per cycle was 1955.94€ for the IV, 1460.01€ for the SC and 1729€ for the biosimilar (p<0.001). The sensitivity analysis showed that it would be necessary for the cost of the IV biosimilar to be 34% lower than the price of SC rituximab to make a difference.
Conclusion: This study shows a reduction in the cost with the administration of SC rituximab in real life compared with using the IV original rituximab and the biosimilar. This information is relevant for healthcare managers and administrations and applies only in the case of drugs with SC original presentations still not available in their correspondent biosimilars.

Keywords: cost analysis, rituximab, intravenous, subcutaneous, biosimilar

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