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Observational Study
. 2024 Oct 31;24(1):1322.
doi: 10.1186/s12913-024-11719-0.

The administration of immune checkpoint inhibitors via an elastomeric pump versus conventional intravenous infusion: an economic perspective

Michiel Zietse #  1 , Ruben Malmberg #  2   3 , Roelof W F van Leeuwen  2   3 , Frederick W Thielen  4   5 , Carin A Uyl-de Groot  4   5
Affiliations
Observational Study

The administration of immune checkpoint inhibitors via an elastomeric pump versus conventional intravenous infusion: an economic perspective

Michiel Zietse et al. BMC Health Serv Res. .

Abstract

Background: Recent studies have underscored the potential of innovative administration methods to mitigate the capacity burden on healthcare systems, without compromising the quality of care. This study assessed and compared the resource utilization and associated costs of two distinct administration modes of immune checkpoint inhibitors: the innovative elastomeric pump and conventional intravenous infusion. This comparison can inform sustainable healthcare practices and healthcare decision-making to optimize treatment efficiency in an era of escalating healthcare demands.

Methods: In this micro-costing study, data on resource use and time allocation for drug preparation and administration were collected using an observational, non-interventional study design. Data were registered at the oncology daycare unit and hospital pharmacy. Cost categories included drug acquisition, disposable materials, healthcare professional time for drug administration, drug preparation, and patient time spent at the oncology day care unit.

Results: Drug administration through the elastomeric pump resulted in substantially lower healthcare costs when compared to conventional infusion, particularly due to reduced labor and chair time. The elastomeric pump reduced the total chair time by 78% and nurse time by 55%. Total average costs (excluding drug costs) were €103,47 and €77.99 for conventional infusion and the elastomeric pump, respectively, showcasing potential savings of €25.48 (P < 0.001) per administration.

Conclusions: This study demonstrated that the elastomeric pump not only offers substantial cost savings but also enhances the treatment capacity of the oncology day care unit. These findings support the adoption of the elastomeric pump in clinical settings as a cost-saving and efficient alternative to conventional infusion.

Trial registration: This study has been registered in the National Trial Register (NTR), with the reference number NTR NL9473. Registration date: 05-05-2021.

Keywords: Efficiency; Elastomeric pump; Immune checkpoint inhibitors; Intravenous infusion; Micro costing; Nivolumab; Pembrolizumab.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Procedures of ICI-B and ICI-P drug preparation and drug administration. ICI-B indicates conventional infusion of immune checkpoint inhibitors; ICI-P, immune checkpoint inhibitors administrated via an elastomeric pump
Fig. 2
Fig. 2
Tornado diagram of the incremental healthcare cost estimates obtained from the one-way deterministic sensitivity analysis. A positive incremental value indicates that ICI-P is cheaper compared to ICI-B. Estimates of minimum input values are in blue and estimates of maximum input values in orange. ICI-B indicates conventional infusion of immune checkpoint inhibitors; ICI-P, immune checkpoint inhibitors administrated via an elastomeric pump
See this image and copyright information in PMC

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