Cost minimization analysis of Herceptin subcutaneous versus Herceptin intravenous treatment for patients with HER2+ Breast cancer in Greece

Aim: To conduct an economic evaluation comparing Herceptin subcutaneous formulation (Herceptin-SC) with Herceptin intravenous formulation (Herceptin-IV), in the treatment of patients with human epidermal growth factor receptor 2-positive (HER2 +) early and metastatic breast cancer (EBC-MBC), in the Greek health care setting. Methods: A cost-minimization model was developed to compare the total cost of care, from the hospital perspective, for new and existing patients, over 18 cycles therapy course. Total cost of therapy reflects drug acquisition cost, consumables dispensed, hospital overheads, physician and other staff time. Costing data were obtained from official Government sources (in 2014) and resource utilization data from a local validation of an international time and motion study. Results: The mean total cost of therapy per patient on Herceptin-IV was estimated at (sic)23,118 compared to (sic)21,870 per patient receiving Herceptin-SC. Drug acquisition costs accounted for (sic)22,311 and (sic)21,738 of total therapy costs for Herceptin-IV and Herceptin-SC, respectively. Following drug acquisition costs, the administration cost was (sic)267 and (sic)64 for Herceptin-IV and Herceptin-SC, respectively. Moreover, the central venous access device cost was (sic)290 and (sic)0 of the total costs of Herceptin IV and Herceptin SC, respectively. Conclusion: Whilst drug costs are even, from an economic perspective treatment with Herceptin-SC is associated with a lower economic burden in comparison to Herceptin-IV in the management of patients with HER2 + EBC and MBC. Hence, the substitution of Herceptin-IV with Herceptin-SC can produce valuable savings for the Greek health care system, especially in the current economic environment where resources are scarce.