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1ISG-006 Economic saving of the preparation of subcutaneous formulations compared to intravenous: focus on daratumumab in three healthcare companies
  1. T Gregori1,
  2. A Ferraioli2,
  3. V Biasi3,
  4. A Vergati1,
  5. G Bagaglini3,
  6. G Bonanni3,
  7. E Giordani2,
  8. A Cavaliere1
  1. 1ASL Viterbo, Hospital Pharmacy, Viterbo, Italy
  2. 2ASL Rieti, UOC Politica del Farmaco e Dispositivi Medici, Rieti, Italy
  3. 3ASL Latina, UOC Assistenza Farmaceutica, Latina, Italy


Background and Importance The new onco-haematological formulations are moving more towards subcutaneous administration which represents a technological innovation compared to intravenous formulations and allows for a greater number of accesses to therapies given the reduced administration times.

Aim and Objectives The objective of this work is to calculate the direct costs of the medical devices necessary for infusion therapy and the indirect costs of the nursing staff responsible for setting up intravenous therapies for daratumumab.

We studied the 2022 data of three local healthcare companies.

Material and Methods With company software we determined the cost of the devices used in intravenous and subcutaneous preparation and the number of patients receiving daratumumab therapy in 2022, considering for each patient 24 cycles of therapy as indicated in the dosage schedules.

Results The cost calculated for a single intravenous preparation is €12.01, considering the following devices necessary for administration:

Two vial-spikes €2.84, two syringes with connectors €2.48, clave-valve €2.76, bag €0.60, syring-luerlock for diluent €0.50, secondary infusion set €2.20, cap-cap €0.25, UV-protector bag €0.25.

The cost for subcutaneous administration is different, equal to €3.29 for vial-spike, syringe and connector, UV-protector bag and cap-cap.

The indirect cost calculated on the average hourly nursing cost of €27.83 and considering a 10-minute set-up commitment for two nursing units is €9.28.

In 2022, 55 patients in healthcare company 1, 69 patients in healthcare company 2, and 12 patients in healthcare company 3 were treated with daratumumab.

Conclusion and Relevance The total cost of the devices and the healthcare staff responsible for preparing the infusion is equal to €21.66 compared to €3.29 for the cost of preparing the subcutaneous injection. The subcutaneous administration is more convenient than intravenous, with a saving of €18.55 per administration. Since the prices of the two formulations of daratumumab are equal, this corresponds to an actual saving.

This saving for the entire year 2022 and for the 24 planned administration cycles would produce a reduction in spending, accounted for in the set-up costs, equal to €24,486 for healthcare company 1, €35,885 for healthcare company 2, and €6,241 for healthcare company 3.

To this we must add an increase in the safety of the operators who prepare and administer, greater patient compliance and a decrease in the social costs of the patient undergoing therapy.

Conflict of Interest No conflict of interest.

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