Subcutaneous (SC) administration of bortezomib is the most widely used route of administration for the treatment of patients with multiple myeloma. No study has as yet prospectively evaluated home versus hospital administration of SC bortezomib with respect to patient preference and cost.
PATIENTS AND METHODS
In this prospective trial, myeloma patients received the first administration of SC bortezomib of each cycle in the outpatient unit of the Hematology Department. When possible, all subsequent doses of bortezomib within each cycle were provided at home. A cost analysis was performed to compare the average cost of an injection of bortezomib in the outpatient unit and at home. In order to compare hospital and home administration of bortezomib for preference and satisfaction, patients had to complete 2 simple questionnaires analyzing 16 criteria, such as quality of life, well-being, social life, satisfaction, safety, quality of care, the reduction in personal transportation time, personal anxiety. Each item was analyzed using a Likert scale RESULTS: Fifty patients were studied. Overall, a total of 1043 SC injections of bortezomib were performed, 655 (62.8%) at home, and 388 (35.2%) in the outpatient unit. The cost analysis showed that the total cost of one SC injection of bortezomib in the outpatient unit was €1510.09 vs €1224.57 for the home administration, which represents a reduction of €285.52, i.e. 20% of the cost of the hospital administration. The evaluation of patient preference and satisfaction showed that home administration improved the quality of life in 84% of the patients, increased well-being in 78% and improved the activities of daily living in 72% of the cases. Overall 98% of the patients noted their preference for home administration over the hospital administration of bortezomib.
Home administration of SC bortezomib is cost-effective and is preferred by myeloma patients compared to hospital administration.