PCN97 ANALYSIS OF THE OPERATING COSTS FROM THE CHEMOTHERAPY SERVICES IN THE COSTA RICAN SOCIAL SECURITY (CCSS) RELATED TO THE ADMINISTRATION OF MEDICINES INTRAVENOUS COMPARED TO SUBCUTANEOUS: VALIDATION IN THE CASE OF TRASTUZUMAB

Abstract

To estimate the average operating cost per minute (AOCM) of one unit for administration of chemotherapy (UAC) in the CCSS, assess the existing installed capacity (IC), and its use, in order to use this data as input in the cost minimization study of two preparations of the monoclonal antibody trastuzumab for the adjuvant treatment of HER 2+ breast cancer, one to be administered intravenously and other one subcutaneously. We used the building, maintenance and equipment costs registered in the UAC from one national reference hospital, recently built, assessed its IC and from that information determined the AOCM; then, we described all the process from the arrival of patient, the preparation of medication, administration and discharge, for each route of administration, and then, compared each other, estimating its cost. We determined the AOCM in $0,44 US dollars per minute, 87% of it is defined by human resources. The current demand on UAC has an annual growth of 6,3%, IC is insufficient to attend this demand in normal working hours, so it is required extraordinary shifts. The time needed to administer one treatment with intravenous trastuzumab is five times greater than with the subcutaneous preparation. The use of subcutaneous preparation of trastuzumab offers an advantage to CCSS in terms of opportunity and financial costs, derived from a diminished time required to prepare and administer medication, which is critical considering that IC has been surpassed.