Cecile BLEIN has been Graduated from january 2009 as Economist Doctor, from the National University of Lyon. She obtained, as part of her thesis, the public health prize awarded by the French mutual society of the Rhône. Then she started working in the Regional Health Agency in charge of prospective payment for health facilities. Presently she has been working at HEVA company as a health economist based in Lyon, France for 6 years where she has continued his research.




Different published clinical studies have demonstrated the non-inferiority of trastuzumab subccutaneous (SC) administration versus intravenous (IV) in terms of efficacy, safety and preference in the treatment of patients with HER2 positive [1-2] . Health facilities wanted to have a multicenter evaluation, using data collected in real life, of the economic impact generated beween the two administrations forms.

A sampling plan from 9 health facilities have been conducted to collect economic consumables data for breast cancer patients care pathway’s (all stages) under trastuzumab (IV versus SC). The economic perspective retained was health facilities.

Multicentric evaluation collected 417 questionnaires describing the care pathway of 411 patients, including 245 patients treated within a SC administration form (60%) versus 167 patients within an IV form (40%).

The average cost of consumables for preparation and administration, expressed in euro 2016, is €1.35 VAT (± €0.47) with the SC routes and €12.42 VAT (± €2.20) with the IV routes. Per patient SC administration resulted in significantly cost saving of €11.07 VAT (± €1.36).

The average transport cost for a patient treated within a SC administration form is €17.57 VAT(± €13.97) and €22.22 VAT (± €13.93) within an IV form. This cost is significantly lower by €4.65 VAT(± €13.95) for the SC form. This result is induced by the correlation existing between the patient mode of transport (light health vehicle or personal transport) and the administration form. A more important mode of hospital exit per light health vehicle for the IV form is significantly observed.