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Cost Analysis of Intravenous vs Subcutaneous Rituximab for Patients With NHL
Study findings suggest a 20% transition from intravenous (IV) to subcutaneous administration of rituximab for patients with non-Hodgkin lymphoma (NHL) has the potential to generate significant US health system value in the form of payer savings, increased practice capacity, and patient time (PLoS One. 2022; 17[1]:e0261336. doi:10.1371/journal.pone.0261336).
“Subcutaneous administration of rituximab provides an opportunity for reduced patient treatment burden and increased healthcare efficiencies as an alternative to IV rituximab,” wrote Michael J Harvey, PhD, Analysis Group, Inc., London, United Kingdom, and colleagues.
“There is minimal evidence comparing costs associated with subcutaneous and IV rituximab in a US setting,” they added.
This study aimed to assess the impact of transitioning patients with NHL from IV to subcutaneous rituximab from the US payer, provider, and patient perspective.
Researchers developed a model to estimate cost differences for transitioning 20% of a patient cohort from IV to subcutaneous rituximab. Data from published literature and publicly available data on patients with incident diffuse large B-cell lymphoma, incident and recurrent follicular lymphoma, and incident and recurrent chronic lymphocytic leukemia were included.
The model was designed so that each patient received the same number of doses, with no differences in discontinuation between cohorts due to non-inferior efficacy and a similar safety profile.
Upon testing the impact of availability of low-cost biosimilars, results from the base case (1,000,000 covered lives) revealed that, among an estimated total of 157 patients, with 769 total drug administrations, a transition of 20% of patients from IV to subcutaneous rituximab was projected to generate $153,000 in payer savings, increase provider capacity by 270 hours, and free 470 hours of patient time.
Further analysis revealed that subcutaneous administration will be cost saving for payers even with a market where biosimilars approach 50% market share.
“A 20% transition to subcutaneous rituximab in a single cohort of patients has the potential to generate significant US health system value in the form of payer savings, increased practice capacity, and patient time,” concluded Dr Harvey and colleagues.
