Intravenous or subcutaneous natalizumab in patients with relapsing-remitting multiple sclerosis: investigation on efficiency and savings-the EASIER study

复发缓解型多发性硬化症患者静脉或皮下注射那他珠单抗:疗效和节省调查-EASIER 研究

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作者:Massimo Filippi, Luigi Grimaldi, Antonella Conte, Rocco Totaro, Maria Rosaria Valente, Simona Malucchi, Franco Granella, Cinzia Cordioli, Vincenzo Brescia Morra, Chiara Zanetta, Daria Perini, Laura Santoni; EASIER Study Working Group

Conclusions

SC natalizumab administration will consistently reduce consumption of patient and HCP times per procedure and associated costs.

Methods

The EASIER study has three parts: (1) time and motion study to measure healthcare resources and working time needed for natalizumab IV administration using a digital data collection tool operated directly by HCPs; (2) HCP structured questionnaire-based estimation of the potential impact of natalizumab SC vs. IV administration; and (3) patient survey on the burden of natalizumab administration.

Results

Nine Italian multiple sclerosis (MS) centers measured 404 IV natalizumab administration procedures and administered 26 HCP questionnaires and 297 patient questionnaires. Patients had a mean of 52 (range 1-176) previous IV administrations and spent a mean (median, IQR) of 152 (130, 94-184) minutes in the center per each IV procedure, with IV infusion covering 50% of the total. Including patient travel time, an average of 5 h was dedicated to each IV administration. Active working time by HCP amounted to 29 min per IV administration procedure, 70% of which by nursing staff. With adoption of the SC route, HCPs estimated a 50% reduction in patient procedure time and 55% lower HCP active working time. This translated into a 63% cost reduction for the MS center per natalizumab administration procedure. Conclusions: SC natalizumab administration will consistently reduce consumption of patient and HCP times per procedure and associated costs.

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