Subcutaneous Drugs In Oncology: Make A Difference In The Treatment? Systematic Review From Different Analytical Perspectives

Abstract

Compare time and economic benefits of the biotechnological subcutaneous (SC) drugs versus intravenous (IV) drugs in oncology. A search of systematic reviews of economic literature, observational and economic studies, official or public policy documents of drug regulatory agencies of reference for Colombia, and INAHTA’s Health Technology Agencies, was carried out. The population was adults who required an IV treatment in room, also available as SC formulation. The databases Medline, Embase, Econlit and HTA were consulted. The quality of the evidence was evaluated with QHES and AMSTAR. Measures of central tendency and qualitative analysis were used in the final analysis. The third payer, insurer, provider and patient perspectives were considered. 33 articles were included. With SC formulation, the average preparation time in pharmacy was less than with IV (19,1 [12,5] vs. 39,45 [SD 0,845] hours), as well as the median time of administration (3,4 [IQR 3-3,5] vs. 25 [IQR 15,69-60] minutes); the saving time in infusion chair was 55,2 minutes (IQR 46,25-92,9) and the time of visit per session was 55,1 minutes (IQR 40,25-174,75). The time spent by health professionals decreased 18,6 minutes (IQR 8,25-38). The 81,75% of patients preferred SC administration. The estimated median savings in the course of the overall treatment of a patient was €1.121 (IQR €611-€4.605) and payers reported €2.919.796 (IQR €531.781-€14.175.000) in savings in the budget. The SC administration of biotechnological drugs in Oncology is an efficient choice for the use of resources in health, providing a better quality of life to the patients, without affecting the safety and effectiveness of the treatments. Also is preferred by patients, reduces the direct and indirect costs, optimizes the productivity of professionals in health and allows a greater availability of infusion rooms. A holistic view of the health technologies from different perspectives is important for evidence-based decision-making in health.