Abstract PS9-55: Subcutaneous fixed-dose combination of pertuzumab and trastuzumab for the treatment of metastatic breast cancer in Canada - a budget impact analysis
Bibliographic record
Abstract
Abstract Background: Recently, the FeDeriCa trial investigated a fixed-dose combination (FDC) of Perjeta and Herceptin (PH), administered by subcutaneous (SC) injection, and demonstrated non-inferior pharmacokinetics of serum Perjeta and Herceptin levels compared to PH IV, along with a similar efficacy and safety profile to the intravenous (IV) administration of PH. In Canada, the standard of care for first-line HER2-positive metastatic breast cancer (mBC) is PH plus taxane chemotherapy with PH until disease progression. Currently, PH are administered as sequential IV infusions. SC administration of PH FDC has the potential to relieve pressure on the healthcare system, decrease treatment burden, and improve the patient experience. Objective: To estimate the incremental costs/savings, including time savings, associated with the use of PH FDC SC for the treatment of HER2+ mBC, if reimbursed with the same provincial funding criteria as PH IV in Ontario and Quebec, Canada. Methods: An Excel-based budget impact model was developed to determine the economic impact of PH FDC SC in comparison to PH IV in Ontario and Quebec. Direct medical costs in the analysis included drug acquisition, drug preparation and administration, and systemic therapy infusion chair/suite costs. Nurse and pharmacist wages were obtained from the Government of Canada’s Job Bank. Systemic therapy infusion chair/suite costs were derived from literature. Data related to time associated with preparation and administration of PH FDC SC and PH IV were collected through a survey completed by nurses and pharmacists involved in the FeDeriCa clinical trial in Canada. Results: HER2+ mBC patients treated with PH FDC SC generate net cost savings to the health system compared to treatment with PH IV. These cost savings to the health system are generated due to fewer costs associated with drug acquisition, pharmacist and nurse wages directed towards drug preparation and administration respectively, as well as fewer overhead costs associated with the infusion chair/suite for PH FDC SC compared to PH IV. The use of PH FDC SC provides the healthcare payer with the opportunity to optimize drug and medical resources appropriately while offering a therapy that is aligned with patient and clinician preferences. Citation Format: Kaushik Sripada, Siddhi Manjrekar, Kristoph Klein-Panneton, Megan Coombes, Cristiano Ferrario. Subcutaneous fixed-dose combination of pertuzumab and trastuzumab for the treatment of metastatic breast cancer in Canada - a budget impact analysis [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS9-55.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".