Societal cost of subcutaneous and intravenous trastuzumab for HER2-positive breast cancer – An observational study prospectively recording resource utilization in a Swedish healthcare setting

Olofsson S, Norrlid H, Karlsson E, Wilking U & Ragnarson Tennvall G

Societal cost of subcutaneous and intravenous trastuzumab for HER2-positive breast cancer – An observational study prospectively recording resource utilization in a Swedish healthcare setting

Trastuzumab is one of the corner stone of the standard treatment for HER2-positive breast cancer. Trastuzumab has historically been administered through intravenous (IV) infusions but an equally safe and effective subcutaneous (SC) formulation received European market approval in 2013. This study aimed to compare the societal value of SC and IV trastuzumab in a Swedish setting.

Each year, approximately 8000 individuals are diagnosed with breast cancer in Sweden. Out of these, 15 to 25 percent comprise a subgroup with human epidermal growth factor receptor-2 (HER2) positive breast cancer for which trastuzumab, a monoclonal antibody that interferes with the HER2 receptor and inhibits the growth of cancer cells, is part of the standard treatment.

For this study, female patients with HER2-positive breast cancer who received SC or IV trastuzumab were consecutively enrolled from five Swedish oncology clinics from 2013 to 2015. In total, 101 IV and 94 SC patients were included and data on time and resource utilization was collected prospectively using patient and nurse questionnaires.

The study showed that SC trastuzumab was associated with lower societal costs than IV trastuzumab, which was partly explained by IV treatment being more time consuming for both for nurses and patients. The study also found that a majority of patients preferred SC to IV administration.

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The Breast 2016; 29: 140-146
DOI: 10.1016/j.breast.2016.07.008