The value of time savings in breast cancer therapy for patients and healthcare providers: the subcutaneous injection of pertuzumab and trastuzumab fixed-dose combination at a tertiary care center in the UAE

Aim: To measure time saving associated with the subcutaneous (SC) fixed-dose combination of pertuzumab and trastuzumab (PH FDC SC) compared with intravenous (IV) pertuzumab and trastuzumab in patients with HER2-positive breast cancer. Materials & methods: This was a single-center local observational study consisting of a retrospective chart review of patients who received PH FDC SC or IV pertuzumab and trastuzumab in the UAE. Eligible patients were adults aged ≥18 years diagnosed with early or metastatic breast cancer. Data collected included demographics, treatment indication and nursing documentation of medication administration. The primary end point was a composite of patient length of stay during administration of SC versus IV pertuzumab and trastuzumab, and pharmacist preparation time. For secondary end points, annual clinical hours saved were extrapolated based on a 100% switching rate for a cohort of 75 patients undergoing 18 cycles annually (1350 visits). Results: Fifty patients with three visits per patient were included in the final analysis; PH FDC SC was administered in 50% of the visits resulted in a total of 150 occurrences of treatment administration. The mean age was 47.0 ± 10.9 years. Patients' length of stay was significantly shorter in the SC arm by a mean difference of 190.9 ± 13.6 min saved per patient (95% CI: 163.9, 217.9). Median pharmacist preparation time was significantly shorter (8 min [Q1: 4; Q3: 15]; p = 0.006) with the SC formulation compared with the IV formulation (13 min [Q1: 6; Q3: 28]). When extrapolated, switching to the SC formulation would save 2468.25 clinical hours saved annually across nursing and pharmacy services. Conclusion: PH FDC SC was associated with significant time savings for both patients and healthcare providers. The transition to SC administration unlocked 2468.25 clinical hours annually, translating into notable indirect cost reductions through optimized resource utilization and improved operational efficiency compared with IV administration.