An estimate of the cost of administering intravenous biological agents in Spanish day hospitals

Abstract

ObjectiveTo estimate the unit costs of administering intravenous (IV) biological agents in day hospitals (DHs) in the Spanish National Health System.Patients and methodsData were obtained from 188 patients with rheumatoid arthritis, collected from nine DHs, receiving one of the following IV therapies: infliximab (n=48), rituximab (n=38), abatacept (n=41), or tocilizumab (n=61). The fieldwork was carried out between March 2013 and March 2014. The following three groups of costs were considered: 1) structural costs, 2) material costs, and 3) staff costs. Staff costs were considered a fixed cost and were estimated according to the DH theoretical level of activity, which includes, as well as personal care of each patient, the DH general activities (complete imputation method, CIM). In addition, an alternative calculation was performed, in which the staff costs were considered a variable cost imputed according to the time spent on direct care (partial imputation method, PIM). All costs were expressed in euros for the reference year 2014.ResultsThe average total cost was €146.12 per infusion (standard deviation [SD] ±87.11; CIM) and €29.70 per infusion (SD ±11.42; PIM). The structure-related costs per infusion varied between €2.23 and €62.35 per patient and DH; the cost of consumables oscillated between €3.48 and €20.34 per patient and DH. In terms of the care process, the average difference between the shortest and the longest time taken by different hospitals to administer an IV biological therapy was 113 minutes.ConclusionThe average total cost of infusion was less than that normally used in models of economic evaluation coming from secondary sources. This cost is even less when the staff costs are imputed according to the PIM. A high degree of variability was observed between different DHs in the cost of the consumables, in the structure-related costs, and in those of the care process.

Subcutaneous rather than intravenous ustekinumab induction is associated with comparable circulating drug levels and early clinical response: a pilot study

“…Subcutaneous administration is preferable for patients with poor intravenous access. From an institutional standpoint, the cost of intravenous infusions includes material, staff and structural costs . Infusion suites are a valuable resource and are engaged by various specialties.…”

“…From an institutional standpoint, the cost of intravenous infusions includes material, staff and structural costs. 25 Infusion suites are a valuable resource and are engaged by various specialties. The judicious use of subcutaneous induction serves both to preserve this resource and to avoid delays associated with demand on this service.…”

Cost of early-stage mycosis fungoides treatments in Spain

“…Unit costs were obtained from tariffs published by the autonomous communities, from the Spanish General Council for the Official College of Pharmacists database and medical literature published in the Spanish setting. [40][41][42][43][44][45][46][47] All costs are given in euros for the year 2018 (Table 1).…”