Improved efficiency of daratumumab treatment of multiple myeloma adopting the subcutaneous route: A micro‐costing analysis in three Italian hematology centers

Lorenzo Pradelli(Torino e-district), Massimo Massaia(Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo), Elisabetta Todisco(Ospedale di Circolo di Busto Arsizio), Filíppo Gherlinzoni(Ca' Foncello Hospital), Anna Furlan(Ca' Foncello Hospital), Maria La Targia(Ospedale di Circolo di Busto Arsizio), Elisabetta Grande(Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo), Ignazio Ezio Tripoli(Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo), Francesca Occhipinti(Ospedale di Circolo di Busto Arsizio), Francesco Comello(Ca' Foncello Hospital), Fabrizio Iannello(Janssen (Italy)), Stefania Bellucci(Janssen (Italy))
Cancer Medicine
November 9, 2023
Cited by 11Open Access
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Abstract

Abstract Background Daratumumab is a humanized monoclonal antibody approved for the treatment of adult patients with newly diagnosed or relapsed/refractory multiple myeloma (RRMM). Subcutaneous (SC) formulation proved to be non‐inferior in comparison with intravenous (IV) administration route. This study aimed at assessing the economic and time impact associated with the use of SC versus IV daratumumab in patients with RRMM from the perspective of the hematology center. Methods This was a 5‐month multicenter time‐and‐motion cross‐sectional micro‐costing study conducted in three Italian hematology centers among adult patients diagnosed with RRMM with ongoing treatment with IV or SC daratumumab. Measurements were performed by an ad hoc App. Results Nineteen (20%) IV and 76 (80%) SC administration procedures were measured. Patients spent a mean of 4.85 ± 0.91 or 1.08 ± 0.56 h in the hematology center to receive IV or SC daratumumab, respectively. Healthcare professionals (HCPs) spent a mean of 49.38 ± 16.13 and 20.37 ± 7.88 min of active working time to manage IV and SC administrations, respectively. The infusion chair was occupied for a mean of 4.85 ± 0.91 and 0.99 ± 0.55 h during IV or SC administration, respectively. On average, considering the costs due to HCP and chair time, materials, and overhead costs, every IV and SC administration costed €80.33 and 34.90, respectively. Conclusions In conclusion, as compared with IV administration, SC daratumumab was associated with 78%, 59%, 80% savings in terms of patient time, HCP active working time, and infusion chair, respectively, and 56.6% budget savings.


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