TY - JOUR
T1 - Hospital-based or home-based administration of oncology drugs? A micro-costing study comparing healthcare and societal costs of hospital-based and home-based subcutaneous administration of trastuzumab
AU - Franken, Margreet
AU - Kanters, Tim
AU - Coenen, JL
AU - De Jong, P
AU - Jager, Agnes
AU - Uyl - de Groot, Carin
PY - 2020
Y1 - 2020
N2 - Objective: To investigate resource use and time investments of healthcare professionals, patients and
their family and to compare healthcare and societal costs of one single hospital-based and one single
home-based subcutaneous administration of trastuzumab in The Netherlands.
Method: We conducted a bottom-up micro-costing study. Patients diagnosed with HER2þ early or
metastatic breast cancer were recruited in four Dutch hospitals. For healthcare costs, data were collected
on drug use, consumables, use of healthcare facilities, time of healthcare professionals, and travelling
distance of the nurse. For societal costs, data were collected on patient and family costs (including
travelling expenses and time of informal caregivers) and productivity losses of paid and unpaid work.
Results: Societal costs of one single administration of SC trastuzumab were V1753 within the homebased
and V1724 within the hospital-based setting. Drug costs of trastuzumab were identical in both
settings (V1651). Healthcare costs were higher for home-based administration (V91 versus V47) mainly
because of more time of healthcare professionals (110 versus 38 minutes). Costs for patient and family
were, however, lower for home-based administration due to travelling expenses (V7 versus V0) and time
of informal caregivers (V14 versus V4). Costs for productivity losses were similar for both settings.
Conclusions: Home-based subcutaneous administration of trastuzumab is more time consuming for
healthcare professionals and therefore more costly than hospital-based administration. The total budget
impact can be large considering that a large number of patients receive a large number of cycles of
oncology treatments. If home-based administration is the way forward, novel approaches are crucial for
ensuring efficiency of home-based care.
AB - Objective: To investigate resource use and time investments of healthcare professionals, patients and
their family and to compare healthcare and societal costs of one single hospital-based and one single
home-based subcutaneous administration of trastuzumab in The Netherlands.
Method: We conducted a bottom-up micro-costing study. Patients diagnosed with HER2þ early or
metastatic breast cancer were recruited in four Dutch hospitals. For healthcare costs, data were collected
on drug use, consumables, use of healthcare facilities, time of healthcare professionals, and travelling
distance of the nurse. For societal costs, data were collected on patient and family costs (including
travelling expenses and time of informal caregivers) and productivity losses of paid and unpaid work.
Results: Societal costs of one single administration of SC trastuzumab were V1753 within the homebased
and V1724 within the hospital-based setting. Drug costs of trastuzumab were identical in both
settings (V1651). Healthcare costs were higher for home-based administration (V91 versus V47) mainly
because of more time of healthcare professionals (110 versus 38 minutes). Costs for patient and family
were, however, lower for home-based administration due to travelling expenses (V7 versus V0) and time
of informal caregivers (V14 versus V4). Costs for productivity losses were similar for both settings.
Conclusions: Home-based subcutaneous administration of trastuzumab is more time consuming for
healthcare professionals and therefore more costly than hospital-based administration. The total budget
impact can be large considering that a large number of patients receive a large number of cycles of
oncology treatments. If home-based administration is the way forward, novel approaches are crucial for
ensuring efficiency of home-based care.
UR - https://www.sciencedirect.com/science/article/pii/S0960977620301089
U2 - 10.1016/j.breast.2020.05.001
DO - 10.1016/j.breast.2020.05.001
M3 - Article
C2 - 32447129
SN - 0960-9776
VL - 52
SP - 71
EP - 77
JO - Breast
JF - Breast
ER -