The Real-Time Nondrug Cost Savings of Switching Patients With Inflammatory Bowel Disease From Intravenous to Subcutaneous Vedolizumab: A Time and Motion Study

Background:
Vedolizumab, a standard biologic therapy for ulcerative colitis (UC), is traditionally administered intravenously. While the recent availability of subcutaneous (SC) vedolizumab has demonstrated comparable efficacy and drug cost savings, the associated non–drug-related costs have not been extensively studied. Therefore, the aim of this study was to assess patient and healthcare provider time, as well as associated healthcare costs, associated with SC vedolizumab therapy.
Methods:
A prospective time and motion study was conducted in 34 UC patients switched from IV to SC vedolizumab. Data on infusion time, nurse time, pharmacy time, physician time, patient hospital time, and related costs were collected for IV vedolizumab. SC vedolizumab incurred no such costs.
Results:
A total of 34 patients were included in the study, of which 20 had ulcerative colitis. Vedolizumab was administered intravenously at intervals of 4 weeks (35%), 6 weeks (6%), and 8 weeks (59%). The mean infusion time was 35 minutes, with an average total patient time, including travel and hospital wait times, of 5 hours and 36 minutes. Healthcare provider time, including nurses (1.00 standard deviation, SD± 0.18 hours per infusion), pharmacists (0.18 standard deviation, SD± 0.03 hours per infusion), and physicians (0.33 SD ± 0.01 hours per infusion), significantly contributed to overall treatment costs. The average cost per IV infusion that included nurse (Saudi Arabia Riyal (SAR) 55.55 ± 16.02), pharmacy (SAR 19.25 SD ± 3.50), physician (SAR 42.40 SD ± 8.28), material supplies (SAR 99.87), facility and administrative costs (SAR 102.31) was approximately SAR 319.38. Therefore, the average annual cost per patient for IV infusions varied based on the infusion interval, with an overall average of SAR 3420.23. Patient productivity losses per infusion were estimated at SAR 383.94, adding SAR 2303.64 annually to the total nondrug costs. This resulted in a total nondrug cost of SAR 3606.06 per patient.
Conclusions:
This study highlights the potential for substantial time and cost savings with SC vedolizumab. By eliminating hospital visits, infusion-related personnel, and supplies, SC vedolizumab offers a more efficient and cost-effective treatment. Larger studies are needed to confirm these findings and assess long-term impacts on patient outcomes and healthcare resource utilization.