A time-in-motion study of oral ibandronate versus iv zoledronic acid for treatment of metastatic bone disease in breast cancer patients

Abstract

6123 Background: Oral bisphosphonates avoid time for administration and monitoring and use of infusion supplies associated with iv bisphosphonates. We used time-in-motion methods in a pharmacoeconomic sub-study to a clinical trial of oral ibandronate vs iv zoledronic acid to estimate medical resource use differences. Methods: At the Week 8 study visit, detailed assessments of resource use were made in patients receiving oral ibandronate 50mg/day (n=19) or iv zoledronic acid 4mg every 3–4 weeks (n=17) at six outpatient clinics in Belgium, Switzerland, Russia and the UK. Staff time associated with bisphosphonate administration, laboratory tests, infusion supplies and medications were recorded. Results: Most patients (94% of ibandronate and 88% of zoledronic acid patients) were not receiving iv chemotherapy concurrently. In Western European sites, average clinic time associated with zoledronic acid administration was 1 hr 25 min longer per patient than with ibandronate (Table). Additional infusion supplies were required for zoledronic acid in patients not receiving iv chemotherapy. Medication use and laboratory tests were similar between groups. In the Russian site, mean duration of the Week 8 visit was 2 hr 25 min longer with zoledronic acid, and included a longer mean preparation time before infusion of 229 min. Mean clinician time was also greater with zoledronic acid (47 versus 32 min with ibandronate) and mean nurse time was greater (19 versus 3 min). Some patients were required to stay overnight for infusions, due to transportation needs. Conclusions: Compared with iv zoledronic acid, oral ibandronate provides medical care utilization savings in staff time and infusional supplies. This further assists clinics having high case loads by freeing staff to manage additional patients. The potential benefits will be greatest when patients are receiving oral anticancer therapies or have completed iv chemotherapy. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Roche Roche