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. 2025 Sep 10:84:104573.
doi: 10.1016/j.breast.2025.104573. Online ahead of print.

Capacity and cost benefits of subcutaneous versus intravenous pertuzumab/trastuzumab: The EASE-SC study

Michiel Zietse  1 , Jacky Hu  2 , Esther R van Staveren  3 , Leontine E A M M Spierings  3 , Agnes Jager  4 , Birgit C P Koch  2 , Ron H J Mathijssen  4 , Roelof W F van Leeuwen  2 , Frederick W Thielen  5
Affiliations

Capacity and cost benefits of subcutaneous versus intravenous pertuzumab/trastuzumab: The EASE-SC study

Michiel Zietse et al. Breast. .

Abstract

Objectives: Subcutaneous administration of pertuzumab and trastuzumab offers a faster alternative to intravenous infusion for patients with HER2-positive breast cancer. However, real-world data on its impact on costs and capacity remain limited. Therefore, this study aimed to compare healthcare resource utilization and costs associated with subcutaneous versus intravenous administration of pertuzumab and trastuzumab from a societal perspective.

Methods: This study was conducted at two Dutch hospitals. Observational data were collected on drug preparation, administration times, and resource use for both formulations. Patient questionnaires assessed societal costs, including travel expenses and productivity losses. Costs were calculated for patient chair time, healthcare professional time, disposables, societal expenses, and drug costs. A nationwide impact analysis estimated potential capacity and productivity gains from switching from intravenous to subcutaneous administration across the Netherlands.

Results: Subcutaneous administration reduced patient chair time compared to intravenous administration, by an average of 106 min (85.5%) for maintenance doses (from 124.3 to 18.1 min) and 287 min (96.0%) for loading doses (from 299.0 to 12.0 min). Active healthcare professional time decreased by 17 min (54.1%) for maintenance doses and 25 min (66.7%) for loading doses. Drug administration costs (excluding drug costs) were lower subcutaneous administration saved approximately €172 per maintenance dose and €403 per loading dose. Nationwide adoption could create capacity for around 22,000 additional treatments annually and save 4.0 full-time equivalent healthcare professionals.

Conclusion: Switching from intravenous to subcutaneous pertuzumab/trastuzumab administration substantially reduces healthcare resource use and may offer cost savings, supporting more efficient delivery of HER2-targeted therapies.

Keywords: Cost analysis; HER2-Positive breast cancer; Healthcare resource utilization; Intravenous administration; Microcosting; Pertuzumab and trastuzumab; Subcutaneous administration.

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Conflict of interest statement

Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Average patient chair time per treatment cycle observed during drug administration of intravenous (IV) and subcutaneous (SC) pertuzumab/trastuzumab and standard deviation.
Fig. 2
Fig. 2
Average active healthcare professional time (HCP) per treatment cycle observed during the drug preparation and administration of intravenous (IV) and subcutaneous (SC) pertuzumab/trastuzumab and standard deviation.
See this image and copyright information in PMC

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