Abstract PS9-55: Subcutaneous fixed-dose combination of pertuzumab and trastuzumab for the treatment of metastatic breast cancer in Canada - a budget impact analysis

Abstract

Abstract Background: Recently, the FeDeriCa trial investigated a fixed-dose combination (FDC) of Perjeta and Herceptin (PH), administered by subcutaneous (SC) injection, and demonstrated non-inferior pharmacokinetics of serum Perjeta and Herceptin levels compared to PH IV, along with a similar efficacy and safety profile to the intravenous (IV) administration of PH. In Canada, the standard of care for first-line HER2-positive metastatic breast cancer (mBC) is PH plus taxane chemotherapy with PH until disease progression. Currently, PH are administered as sequential IV infusions. SC administration of PH FDC has the potential to relieve pressure on the healthcare system, decrease treatment burden, and improve the patient experience. Objective: To estimate the incremental costs/savings, including time savings, associated with the use of PH FDC SC for the treatment of HER2+ mBC, if reimbursed with the same provincial funding criteria as PH IV in Ontario and Quebec, Canada. Methods: An Excel-based budget impact model was developed to determine the economic impact of PH FDC SC in comparison to PH IV in Ontario and Quebec. Direct medical costs in the analysis included drug acquisition, drug preparation and administration, and systemic therapy infusion chair/suite costs. Nurse and pharmacist wages were obtained from the Government of Canada’s Job Bank. Systemic therapy infusion chair/suite costs were derived from literature. Data related to time associated with preparation and administration of PH FDC SC and PH IV were collected through a survey completed by nurses and pharmacists involved in the FeDeriCa clinical trial in Canada. Results: HER2+ mBC patients treated with PH FDC SC generate net cost savings to the health system compared to treatment with PH IV. These cost savings to the health system are generated due to fewer costs associated with drug acquisition, pharmacist and nurse wages directed towards drug preparation and administration respectively, as well as fewer overhead costs associated with the infusion chair/suite for PH FDC SC compared to PH IV. The use of PH FDC SC provides the healthcare payer with the opportunity to optimize drug and medical resources appropriately while offering a therapy that is aligned with patient and clinician preferences. Citation Format: Kaushik Sripada, Siddhi Manjrekar, Kristoph Klein-Panneton, Megan Coombes, Cristiano Ferrario. Subcutaneous fixed-dose combination of pertuzumab and trastuzumab for the treatment of metastatic breast cancer in Canada - a budget impact analysis [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-55.