Jovan Mihajlović1, Pieter Bax2, Erwin van Breugel2, Hedwig M Blommestein3, Mels Hoogendoorn4, Wobbe Hospes5, Maarten J Postma6. 1. Department of Pharmacotherapy, Epidemiology, and Economics, University of Groningen, Groningen, the Netherlands; Mihajlović Health Analytics, Novi Sad, Serbia. Electronic address: jovan@miha.rs. 2. Department of Pharmacotherapy, Epidemiology, and Economics, University of Groningen, Groningen, the Netherlands. 3. Institute of Health Policy & Management, Erasmus University, Rotterdam, the Netherlands. 4. Department of Haematology, Medical Center Leeuwarden, Leeuwarden, the Netherlands. 5. Department of Pharmacy, Isala Clinics, Zwolle, the Netherlands; Department of Pharmacy, Ommelander Zorggroep, Winschoten/Delfzijl, the Netherlands. 6. Department of Pharmacotherapy, Epidemiology, and Economics, University of Groningen, Groningen, the Netherlands; Institute of Science in Healthy Aging & health caRE, University Medical Center Groningen, Groningen, the Netherlands.
Abstract
PURPOSE: The goal of this study is to identify and compare all direct costs of intravenous and subcutaneous rituximab given to patients with diffuse large B-cell lymphoma in the Netherlands. METHODS: Using a prospective, observational, bottom-up microcosting study, we collected primary data on the direct medical costs of the preparation, administration, and acquisition of rituximab. Drug costs and costs of drug wastage, labor costs, material costs, and outpatient costs were identified using standardized forms, structured using prices from official pricelists, and compared for the intravenous and subcutaneous forms of rituximab. FINDINGS: Measurements were taken on 53 rituximab administrations (33 intravenous and 20 subcutaneous) and on 13 rituximab preparation (7 intravenous and 6 subcutaneous). The mean total costs were €2176.77 for the intravenous infusion and €1911.09 for the subcutaneous injection. The estimated difference of €265.17 (95% CI, €231.99-`€298.35) per administration was mainly attributable to differences in time spent in the chemotherapy unit, related outpatient costs, drug wastage, and drug costs. IMPLICATIONS: Rituximab administered in the form of subcutaneous injection is less costly than its intravenous form. With their equal effectiveness taken into account, subcutaneous rituximab administration can result in significant savings when transferred to the total diffuse large B-cell lymphoma population in the Netherlands.
PURPOSE: The goal of this study is to identify and compare all direct costs of intravenous and subcutaneous rituximab given to patients with diffuse large B-cell lymphoma in the Netherlands. METHODS: Using a prospective, observational, bottom-up microcosting study, we collected primary data on the direct medical costs of the preparation, administration, and acquisition of rituximab. Drug costs and costs of drug wastage, labor costs, material costs, and outpatient costs were identified using standardized forms, structured using prices from official pricelists, and compared for the intravenous and subcutaneous forms of rituximab. FINDINGS: Measurements were taken on 53 rituximab administrations (33 intravenous and 20 subcutaneous) and on 13 rituximab preparation (7 intravenous and 6 subcutaneous). The mean total costs were €2176.77 for the intravenous infusion and €1911.09 for the subcutaneous injection. The estimated difference of €265.17 (95% CI, €231.99-`€298.35) per administration was mainly attributable to differences in time spent in the chemotherapy unit, related outpatient costs, drug wastage, and drug costs. IMPLICATIONS: Rituximab administered in the form of subcutaneous injection is less costly than its intravenous form. With their equal effectiveness taken into account, subcutaneous rituximab administration can result in significant savings when transferred to the total diffuse large B-cell lymphoma population in the Netherlands.
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