RU2 Potential Time Savings With Trastuzumab Subcutaneous (SC) Injection Versus Trastuzumab Intravenous (IV) Infusion: Results from Interviews Conducted As Part of a Time-and-Motion Study (T&M) Across 17 Sites

Abstract

OBJECTIVES:The Washington Panel on Cost Effectiveness argued that '. . .the best articulation of society's preferences for a particular state would be gathered from a representative sample of fully informed members of the community'. In the UK, NICE currently recommends generic preference-based health-related quality of life questionnaires, namely, the EQ-5D, for use in cost effectiveness analysis. The EQ-5D UK value set was obtained from an uninformed general public sample. Our aim is to investigate what effect information had on valuations of health states. We compared public valuations of health states, which were a) uninformed b) informed with labeling c) informed about the condition d) informed about adaptation to the condition. METHODS: Generic preference-based questionnaires (EQ-5D and SF-6D), the visual analogue scale (VAS) and the time trade-off (TTO) valuation techniques were administered to a sample of patients with age-related macular degeneration (Nϭ60). A general public pilot sample (Nϭ40) were randomised to groups with different types of information about the condition before being presented with patient EQ-5D health states and being asked to value the health states using the TTO. RESULTS: Comparisons were made between public valuations of health states with different types of information about the condition using multiple regression. Public valuations differed across information conditions (pϽ0.05). Groups provided with labeling or disease information value health states more severely while groups provided with information on adaptation valued health states less severely compared to no information. However these effects did not reach statistical significance. CONCLUSIONS: This is the first study to compare the impact of condition-specific information, labeling and adaptation information on health state valuations within the same population. Early results suggest that framing of information leads the public to different valuations, although a larger study is required to confirm this.

Evaluating the administration costs of biologic drugs: development of a cost algorithm

“…Our regression-based algorithm provides a conservative estimate of £940,200 if 200 patients fully switch from intravenous to self-administered subcutaneous trastuzumab. Also De Cock et al [ 23 ] report, from a multi-country, multi-centre time and motion study that resources expended in administering intravenous trastuzumab is mainly in the form of reconstitution in the pharmacy and in "infusion initiation" (no changes in number of patients visits, blood sampling and physician consultation were expected from the switch to subcutaneous trastuzumab). Our results are consistent with this finding as we found that the ratio PAc/Pc is greater than or equal to one in only 9% of 1000 simulations for trastuzumab.…”