Subcutaneous Rituximab Associated With Savings in Time for Patients, Practices Over IV Administration

A recent study evaluated real‐world practice efficiency changes associated with giving brand-name rituximab by subcutaneous injection, rather than intravenous (IV) administration, by studying differences in the amount of time patients spent receiving the therapy for cancer.

The retrospective analysis of practice care delivery measures at Memorial Sloan Kettering Cancer Center (MSKCC) showed substantial time savings for both patients and the healthcare system, researchers report.

Patient data for those receiving rituximab for malignancies from September 2016 to September 2018 were extracted from the electronic medical record. Multiple regression techniques were used to analyze the association between treatment type (IV versus subcutaneous) and chair time (defined as the difference in patient room‐in and room‐out times) in the year prior to and after subcutaneous therapy adoption at MSKCC. Model covariates included treatment time and location, therapy type (monotherapy versus combination) and patient demographics. Since the first dose of rituximab took longer, that session was excluded from the analysis.

Data for 6744 visits (3018 visits prior to subcutaneous adoption and 3726 after) for 1503 patients receiving rituximab were collected.

Patients receiving IV combination therapy had a mean chair time of 203 minutes; overall, subcutaneous injection reduced chair time by a mean of 92 min (P <.001).

Monotherapy, regardless of route, reduced time by a mean of 30 min (P <.001) compared with combination therapy; mean chair time was further reduced by 39 min (P <.001) for subcutaneous patients receiving monotherapy.

During the course of the study, chair time continued to fall after adoption of subcutaneous rituximab (P = .042), and the reductions were greater at the lymphoma&#8208;specific site than multispecialty oncology infusion centers (P <.001).

Given increasing constraints on infusion chair space, increased utilization of subcutaneous rituximab may improve practice efficiency and patient access to care, the researchers concluded.

These findings may have relevance for the US biosimilars market; while a subcutaneously administered version of the brand-name rituximab is FDA-approved, no approved biosimilars have a subcutaneous option. It remains to be seen whether the route of administration will impact clinicians’ choice of the reference or the biosimilar options, and if so, in which settings this may be a factor, and whether biosimilar savings will overcome the benefits of reduced chair time.

Reference

Matasar MJ, Qiu A, Shapouri S, et al. Real&#8208;world assessment of practice efficiency with the introduction of subcutaneous rituximab. Presented at: 15th International Conference on Malignant Lymphoma Palazzo dei Congressi, June 18-22, 2019; Lugano, Switzerland. Abstract 516.