POSITIVE BENEFITS OF CHANGING FROM INTRAVENOUS RITUXIMAB ADMINISTRATION TO SUBCUTANEOUS ADMINISTRATION: A SINGLE UK CENTRE EXPERIENCE
(Abstract release date: 05/19/16)
EHA Library. Irwin S. 06/09/16; 132700; E1151
Mrs. Sarah Irwin
Contributions
Contributions
Abstract
Abstract: E1151
Type: Eposter Presentation
Background
Addition of the anti CD20 monoclonal antibody, rituximab, to chemotherapy regimens for the treatment of B cell non Hodgkin lymphomas has been standard practice in the UK since 2003. The initial licence for rituximab was for intravenous (IV) administration. Subcutaneous (SC) rituximab was granted marketing authorisation in March 2014.Administration of IV rituximab takes between 90 and 270 minutes depending on a number of factors including the chemotherapy regimen used and the number of doses a patient has already received. SC rituximab takes 5-10 minutes to give.Prior to July 2014 80% of rituximab doses given at University Hospital of Wales (UHW) were prepared by our in house pharmacy staff and 20% of doses were bought in ready prepared bags, to allow flexibility in chemotherapy scheduling. SC rituximab is given as a standard dose for all patients and can be made up by nursing staff in the chemotherapy day unit.
Aims
To investigate cost savings and reduction in chair times for patients treated with chemotherapy regimens containing SC rituximab therapy compared to IV rituximab therapy in a single centre in the UK. Infusion related adverse events were also recorded for the study period.
Methods
Following local governance approval, the UHW department of haematology switched from IV to SC rituximab in July 2014. The policy change only applied to patients with a diagnosis of diffuse large B cell lymphoma (DLBCL) or follicular lymphoma (FL) receiving treatment with R-CHOP, R-CVP or R-bendamustine chemotherapy regimens plus any maintenance doses.All dispensed SC doses of rituximab were retrospectively identified from our pharmacy system in 2015. The actual cost of the SC doses was compared to projected drug costs and staff time for doses given IV with 20% pre prepared drug being bought in as prior to 2014.The chemotherapy day unit audited chair time for the same patient group receiving rituximab containing regimens during a 12 month period in 2013 prior to the change in practice and another 12 month period in 2015 post the changes.Patient notes were retrospectively audited for the same 2 time periods in 2013 and 2015 to record documented complications of rituximab administration.
Results
92 patients with DLBCL or FL were treated in 2015, receiving a total of 372 doses of SC rituximab. The annual drug cost savings were estimated at £20K. The reduced time spent by pharmacy staff in the aseptic unit was estimated at 160 hours annually.The chemotherapy administration time audit showed that prior to the policy change, average administration times were as follows: R-CHOP 260 minutes (mins), R-CVP 135 mins, R-bendamustine 180 mins and maintenance rituximab 150 mins. Post July 2014 the average administration times were as follows: R-CHOP 130 mins, R-CVP 50 mins, R-Bendamustine 45 mins and maintenance rituximab 11 mins. This reduction in treatment administration translated into a saving of chair times of 842 hours in 12 months (approximately 72 hrs per month) (Fig 1).Retrospective review of patient notes did not show any increase in adverse events relating to SC rituximab administration.
Conclusion
The introduction of SC rituximab at the UHW resulted in reduced drug costs, reduced staff time in drug preparation and significant reductions in chemotherapy chair time for patients with no evidence of an increase in adverse events relating to drug administration. These savings have freed resources to allow for other therapies to be accommodated into the existing service.
Session topic: E-poster
Keyword(s): Cost analysis, Non-Hodgkin's lymphoma, Rituximab, Subcutaneous
Type: Eposter Presentation
Background
Addition of the anti CD20 monoclonal antibody, rituximab, to chemotherapy regimens for the treatment of B cell non Hodgkin lymphomas has been standard practice in the UK since 2003. The initial licence for rituximab was for intravenous (IV) administration. Subcutaneous (SC) rituximab was granted marketing authorisation in March 2014.Administration of IV rituximab takes between 90 and 270 minutes depending on a number of factors including the chemotherapy regimen used and the number of doses a patient has already received. SC rituximab takes 5-10 minutes to give.Prior to July 2014 80% of rituximab doses given at University Hospital of Wales (UHW) were prepared by our in house pharmacy staff and 20% of doses were bought in ready prepared bags, to allow flexibility in chemotherapy scheduling. SC rituximab is given as a standard dose for all patients and can be made up by nursing staff in the chemotherapy day unit.
Aims
To investigate cost savings and reduction in chair times for patients treated with chemotherapy regimens containing SC rituximab therapy compared to IV rituximab therapy in a single centre in the UK. Infusion related adverse events were also recorded for the study period.
Methods
Following local governance approval, the UHW department of haematology switched from IV to SC rituximab in July 2014. The policy change only applied to patients with a diagnosis of diffuse large B cell lymphoma (DLBCL) or follicular lymphoma (FL) receiving treatment with R-CHOP, R-CVP or R-bendamustine chemotherapy regimens plus any maintenance doses.All dispensed SC doses of rituximab were retrospectively identified from our pharmacy system in 2015. The actual cost of the SC doses was compared to projected drug costs and staff time for doses given IV with 20% pre prepared drug being bought in as prior to 2014.The chemotherapy day unit audited chair time for the same patient group receiving rituximab containing regimens during a 12 month period in 2013 prior to the change in practice and another 12 month period in 2015 post the changes.Patient notes were retrospectively audited for the same 2 time periods in 2013 and 2015 to record documented complications of rituximab administration.
Results
92 patients with DLBCL or FL were treated in 2015, receiving a total of 372 doses of SC rituximab. The annual drug cost savings were estimated at £20K. The reduced time spent by pharmacy staff in the aseptic unit was estimated at 160 hours annually.The chemotherapy administration time audit showed that prior to the policy change, average administration times were as follows: R-CHOP 260 minutes (mins), R-CVP 135 mins, R-bendamustine 180 mins and maintenance rituximab 150 mins. Post July 2014 the average administration times were as follows: R-CHOP 130 mins, R-CVP 50 mins, R-Bendamustine 45 mins and maintenance rituximab 11 mins. This reduction in treatment administration translated into a saving of chair times of 842 hours in 12 months (approximately 72 hrs per month) (Fig 1).Retrospective review of patient notes did not show any increase in adverse events relating to SC rituximab administration.
Conclusion
The introduction of SC rituximab at the UHW resulted in reduced drug costs, reduced staff time in drug preparation and significant reductions in chemotherapy chair time for patients with no evidence of an increase in adverse events relating to drug administration. These savings have freed resources to allow for other therapies to be accommodated into the existing service.
Session topic: E-poster
Keyword(s): Cost analysis, Non-Hodgkin's lymphoma, Rituximab, Subcutaneous
Abstract: E1151
Type: Eposter Presentation
Background
Addition of the anti CD20 monoclonal antibody, rituximab, to chemotherapy regimens for the treatment of B cell non Hodgkin lymphomas has been standard practice in the UK since 2003. The initial licence for rituximab was for intravenous (IV) administration. Subcutaneous (SC) rituximab was granted marketing authorisation in March 2014.Administration of IV rituximab takes between 90 and 270 minutes depending on a number of factors including the chemotherapy regimen used and the number of doses a patient has already received. SC rituximab takes 5-10 minutes to give.Prior to July 2014 80% of rituximab doses given at University Hospital of Wales (UHW) were prepared by our in house pharmacy staff and 20% of doses were bought in ready prepared bags, to allow flexibility in chemotherapy scheduling. SC rituximab is given as a standard dose for all patients and can be made up by nursing staff in the chemotherapy day unit.
Aims
To investigate cost savings and reduction in chair times for patients treated with chemotherapy regimens containing SC rituximab therapy compared to IV rituximab therapy in a single centre in the UK. Infusion related adverse events were also recorded for the study period.
Methods
Following local governance approval, the UHW department of haematology switched from IV to SC rituximab in July 2014. The policy change only applied to patients with a diagnosis of diffuse large B cell lymphoma (DLBCL) or follicular lymphoma (FL) receiving treatment with R-CHOP, R-CVP or R-bendamustine chemotherapy regimens plus any maintenance doses.All dispensed SC doses of rituximab were retrospectively identified from our pharmacy system in 2015. The actual cost of the SC doses was compared to projected drug costs and staff time for doses given IV with 20% pre prepared drug being bought in as prior to 2014.The chemotherapy day unit audited chair time for the same patient group receiving rituximab containing regimens during a 12 month period in 2013 prior to the change in practice and another 12 month period in 2015 post the changes.Patient notes were retrospectively audited for the same 2 time periods in 2013 and 2015 to record documented complications of rituximab administration.
Results
92 patients with DLBCL or FL were treated in 2015, receiving a total of 372 doses of SC rituximab. The annual drug cost savings were estimated at £20K. The reduced time spent by pharmacy staff in the aseptic unit was estimated at 160 hours annually.The chemotherapy administration time audit showed that prior to the policy change, average administration times were as follows: R-CHOP 260 minutes (mins), R-CVP 135 mins, R-bendamustine 180 mins and maintenance rituximab 150 mins. Post July 2014 the average administration times were as follows: R-CHOP 130 mins, R-CVP 50 mins, R-Bendamustine 45 mins and maintenance rituximab 11 mins. This reduction in treatment administration translated into a saving of chair times of 842 hours in 12 months (approximately 72 hrs per month) (Fig 1).Retrospective review of patient notes did not show any increase in adverse events relating to SC rituximab administration.
Conclusion
The introduction of SC rituximab at the UHW resulted in reduced drug costs, reduced staff time in drug preparation and significant reductions in chemotherapy chair time for patients with no evidence of an increase in adverse events relating to drug administration. These savings have freed resources to allow for other therapies to be accommodated into the existing service.
Session topic: E-poster
Keyword(s): Cost analysis, Non-Hodgkin's lymphoma, Rituximab, Subcutaneous
Type: Eposter Presentation
Background
Addition of the anti CD20 monoclonal antibody, rituximab, to chemotherapy regimens for the treatment of B cell non Hodgkin lymphomas has been standard practice in the UK since 2003. The initial licence for rituximab was for intravenous (IV) administration. Subcutaneous (SC) rituximab was granted marketing authorisation in March 2014.Administration of IV rituximab takes between 90 and 270 minutes depending on a number of factors including the chemotherapy regimen used and the number of doses a patient has already received. SC rituximab takes 5-10 minutes to give.Prior to July 2014 80% of rituximab doses given at University Hospital of Wales (UHW) were prepared by our in house pharmacy staff and 20% of doses were bought in ready prepared bags, to allow flexibility in chemotherapy scheduling. SC rituximab is given as a standard dose for all patients and can be made up by nursing staff in the chemotherapy day unit.
Aims
To investigate cost savings and reduction in chair times for patients treated with chemotherapy regimens containing SC rituximab therapy compared to IV rituximab therapy in a single centre in the UK. Infusion related adverse events were also recorded for the study period.
Methods
Following local governance approval, the UHW department of haematology switched from IV to SC rituximab in July 2014. The policy change only applied to patients with a diagnosis of diffuse large B cell lymphoma (DLBCL) or follicular lymphoma (FL) receiving treatment with R-CHOP, R-CVP or R-bendamustine chemotherapy regimens plus any maintenance doses.All dispensed SC doses of rituximab were retrospectively identified from our pharmacy system in 2015. The actual cost of the SC doses was compared to projected drug costs and staff time for doses given IV with 20% pre prepared drug being bought in as prior to 2014.The chemotherapy day unit audited chair time for the same patient group receiving rituximab containing regimens during a 12 month period in 2013 prior to the change in practice and another 12 month period in 2015 post the changes.Patient notes were retrospectively audited for the same 2 time periods in 2013 and 2015 to record documented complications of rituximab administration.
Results
92 patients with DLBCL or FL were treated in 2015, receiving a total of 372 doses of SC rituximab. The annual drug cost savings were estimated at £20K. The reduced time spent by pharmacy staff in the aseptic unit was estimated at 160 hours annually.The chemotherapy administration time audit showed that prior to the policy change, average administration times were as follows: R-CHOP 260 minutes (mins), R-CVP 135 mins, R-bendamustine 180 mins and maintenance rituximab 150 mins. Post July 2014 the average administration times were as follows: R-CHOP 130 mins, R-CVP 50 mins, R-Bendamustine 45 mins and maintenance rituximab 11 mins. This reduction in treatment administration translated into a saving of chair times of 842 hours in 12 months (approximately 72 hrs per month) (Fig 1).Retrospective review of patient notes did not show any increase in adverse events relating to SC rituximab administration.
Conclusion
The introduction of SC rituximab at the UHW resulted in reduced drug costs, reduced staff time in drug preparation and significant reductions in chemotherapy chair time for patients with no evidence of an increase in adverse events relating to drug administration. These savings have freed resources to allow for other therapies to be accommodated into the existing service.
Session topic: E-poster
Keyword(s): Cost analysis, Non-Hodgkin's lymphoma, Rituximab, Subcutaneous
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