Capacity and cost benefits of subcutaneous versus intravenous pertuzumab/trastuzumab: The EASE-SC study

Objectives

Subcutaneous administration of pertuzumab and trastuzumab offers a faster alternative to intravenous infusion for patients with HER2-positive breast cancer. However, real-world data on its impact on costs and capacity remain limited. Therefore, this study aimed to compare healthcare resource utilization and costs associated with subcutaneous versus intravenous administration of pertuzumab and trastuzumab from a societal perspective.

Methods

This study was conducted at two Dutch hospitals. Observational data were collected on drug preparation, administration times, and resource use for both formulations. Patient questionnaires assessed societal costs, including travel expenses and productivity losses. Costs were calculated for patient chair time, healthcare professional time, disposables, societal expenses, and drug costs. A nationwide impact analysis estimated potential capacity and productivity gains from switching from intravenous to subcutaneous administration across the Netherlands.

Results

Subcutaneous administration reduced patient chair time compared to intravenous administration, by an average of 106 min (85.5%) for maintenance doses (from 124.3 to 18.1 min) and 287 min (96.0%) for loading doses (from 299.0 to 12.0 min). Active healthcare professional time decreased by 17 min (54.1%) for maintenance doses and 25 min (66.7%) for loading doses. Drug administration costs (excluding drug costs) were lower subcutaneous administration saved approximately €172 per maintenance dose and €403 per loading dose. Nationwide adoption could create capacity for around 22,000 additional treatments annually and save 4.0 full-time equivalent healthcare professionals.

Conclusion

Switching from intravenous to subcutaneous pertuzumab/trastuzumab administration substantially reduces healthcare resource use and may offer cost savings, supporting more efficient delivery of HER2-targeted therapies.