PDG11 COST MINIMIZATION ANALYSIS OF TRASTUZUMAB SUBCUTANEOUS VERSUS INTRAVENOUS IN TREATMENT OF HER2-POSITIVE EARLY OR METASTATIC BREAST CANCER IN VIETNAM

Abstract

The advent of trastuzumab biological medicine has opened up new strides in treatment of HER2-positive (HER2+) breast cancer. With the same efficacy and safety, trastuzumab subcutaneous (T-SC) is considered more advantagous than intravenous (T-IV) in terms of usability. With higher price of T-SC than T-IV, it is necessary to assess the economic efficiency of T-SC versus T-IV to consider the feasibility of using new therapies in clinical practice with tight medical budgets. Cost minimization analysis was used with cost components including drug cost, labor cost, other costs related to route of use, non-medical direct and indirect costs. The necessary information in the study was collected based on patient interviews and expert opinions at K hospital, Cho Ray hospital, Ho Chi Minh city Oncology hospital, Ha Noi Oncology hospital, Da Nang Oncology hospital and Bach Mai hospital. With an average weight of 54.78 ± 0.49 kg, T-SC is more economical than T-IV for each cycle from 2.51 to 3.65 million VND when not counting waste; from 3.55 to 4.59 million VND when calculating 10% of T-IV wastes and from 12.90 to 13.09 million VND when calculating 100% of T-IV wastes. For the entire course of treatment, T-SC economises from 45.11 to 232.16 million VND in early stage and from 25.52 to 91.65 million VND in metastasis stage depending on the percentage of wastage. In the minimized cost components, drug cost accounts for the highest proportion, fluctuating from 70.52% to 94.27% based on stage and portion of wastage. Other cost components are insignificant and do not change the value in all cases. T-SC is more economical than T-IV in treatment of HER2+ breast cancer in both cases of early and metastasis stage. In particular, drug cost is the most economical.