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2SPD-010 Economic impact of switching the administration route of tocilizumab in polyarticular juvenile idiopathic arthritis
  1. M Rodriguez Reyes1,
  2. F Bossacoma Busquets2,
  3. M Sanchez Celma3,
  4. J Arrojo Suarez3,
  5. A Comes Escoda3,
  6. C Latre Gorbe3,
  7. E Iglesias Jimenez4,
  8. J Anton Lopez4
  1. 1Hospital Clinic Barcelona, Pharmacy, Barcelona, Spain
  2. 2Hospital Sant Joan De Déu/Fundació Salut Empordà, Pharmacy, Esplugues De Llobregat, Spain
  3. 3Hospital Sant Joan De Déu, Pharmacy, Esplugues De Llobregat, Spain
  4. 4Hospital Sant Joan De Déu, Paediatrics, Esplugues De Llobregat, Spain


Background and importance Tocilizumab is a humanised anti-interleukin-6 receptor monoclonal antibody. Intravenous tocilizumab is approved for use in children aged 2 years or older with polyarticular juvenile idiopathic arthritis (PJIA). Recently, subcutaneous tocilizumab was labelled for the same indication, demonstrating efficacy with a similar safety profile as intravenous administration.

Aim and objectives The aim of this study was to analyse treatment costs of subcutaneous tocilizumab (SC-T) versus intravenous tocilizumab (IV-T) in children with PJIA.

Material and methods This was a cross sectional study in a paediatric teaching hospital including all children with PJIA treated with intravenous tocilizumab. Variables collected were: sex, age, weight, posology of IV-T and consumption of vials and monthly cost associated with the use of IV-T. We analysed the potential cost savings if SC-T was used instead of IV-T. Costs were calculated using public prices provided by the health system (349.0€/vial of 200 mg, 244.3€/vial of 80 mg and 139.6€/subcutaneous syringe of 162 mg). The monthly dose of IV-T is 8 mg/kg for patients weighing >30 kg and 10 mg/kg for patients weighing ≤30 kg. The dose of SC-T is 162 mg every 2 weeks in patients weighing >30 kg, and 162 mg every 3 weeks in patients weighing ≤30 kg.

Results Twenty patients were included: 18/20 were female, median age was 12.5 years (IQR 9.5–14.5 years) and median weight was 42.7 kg (IQR 36.4–53.5 kg). In our sample there were no patients weighing <20 kg but it should be noted that in these patients, SC-T was more expensive than IV-T.

Table 1 shows the monthly cost of treatment with intravenous and subcutaneous tocilizumab:

Abstract 2SPD-010 Table 1

Monthly savings in exclusively using SC-T was €4205.45 (median monthly saving per patient €210.27), which represents a decrease of 30.9% in cost.

Conclusion and relevance The use of subcutaneous tocilizumab in PJIA could represent a considerable saving. Furthermore, subcutaneous administration reduces the treatment burden for patients, self-administration results in fewer absences from school as well as improved resource utilisation at the treatment facility.

References and/or acknowledgements No conflict of interest.

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