title: Abraxane® versus Taxol® for patients with advanced breast cancer: A prospective time and motion analysis from a Chinese health care perspective.
abstract: BACKGROUND
  Abraxane® and Taxol® are both effective drugs for the treatment of advanced stage breast cancer. However, each agent possesses unique drug delivery characteristics with the former not requiring premedication and having a considerably shorter recommended infusion time (i.e. 30 min vs. 2-4 h). To measure the overall efficiency and cost-saving potential associated with Abraxane® relative to Taxol®, a time and motion study was undertaken in breast cancer patients treated in China.
  
  
  METHODS
  Baseline patient data collection included age, disease stage, number and sites of metastatic disease, and performance status. Time and resource use data were then collected from breast patients being treated with Abraxane® (n = 12) or Taxol® (n = 15) in one of three cancer clinics located in Jiangsu, Shanghai, and Beijing. Resource use and time impact on clinical staff were quantified using unit cost estimates. This included costs for drug preparation, administration, materials and supplies, premedication, patient chair time, labor costs, and all acute adverse drug reactions. Outcomes were presented as a mean total time and cost for delivering a dose of Abraxane® or Taxol® and were compared using parametric and non-parametric statistical tests where appropriate. All costs were reported in US dollars (US$1 = 6.1 RMB, as of January 2014).
  
  
  RESULTS
  Patients were comparable with respect to mean age, number of metastatic sites, and performance status. Approximately 9 of 12 (75%) patients received Abraxane® as on a weekly schedule (vs. every 3 weeks) compared to 6 of 15 (40%) with Taxol®. There were 5 (33.3%) acute adverse drug reactions with Taxol®, 3 of which required a physician visit and the initiation of supportive interventions. In contrast, there was only one minor event with Abraxane® (8.3%), which was easily managed with a temporary stoppage of the infusion. From the time and motion study, the mean total time for Abraxane® and Taxol® delivery (preparation, administration, premedication, total chair time, and adverse effects management) was 84 and 282 min respectively (p < 0.001), with the associated costs being US$59 and US$254 respectively per dose (p < 0.001).
  
  
  CONCLUSIONS
  To our knowledge, this is first such study in breast cancer patients to be undertaken in China. Abraxane® was associated with fewer acute adverse drug reactions and significant reductions in health care resources, physician/nurse time and overall drug delivery costs compared to Taxol®.
authors.affiliation: Augmentium Pharma Consulting, Toronto, Canada george@augmentium.com.
authors.forename: George
authors.initials: G
authors.lastname: Dranitsaris
authors.affiliation: Cancer Hospital of Fu Dan University, Shanghai, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Yu
authors.affiliation: Cancer Hospital of Fu Dan University, Shanghai, China.
authors.forename: Leiping
authors.initials: L
authors.lastname: Wang
authors.affiliation: Jiangsu Provincial Cancer Hospital, Jiangsu, China.
authors.forename: Weili
authors.initials: W
authors.lastname: Sun
authors.affiliation: Shanghai Centennial Scientific, Shanghai, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Celgene Corporation, Summit, NJ, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: King
authors.affiliation: Celgene Corporation, Summit, NJ, USA.
authors.forename: Satyin
authors.initials: S
authors.lastname: Kaura
authors.affiliation: Celgene Corporation, Summit, NJ, USA.
authors.forename: Adams
authors.initials: A
authors.lastname: Zhang
authors.affiliation: Chinese Academy of Medical Science, Beijing, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Yuan
mesh_terms: D000328:Adult; D000368:Aged; D000068196:Albumin-Bound Paclitaxel / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D002681:China / Q000453:epidemiology; D003695:Delivery of Health Care / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017239:Paclitaxel / Q000627:therapeutic use*; D011446:Prospective Studies; D013996:Time and Motion Studies
chemical_list: D000068196:Albumin-Bound Paclitaxel; D000970:Antineoplastic Agents; D017239:Paclitaxel
keywords: Abraxane®; cost analysis; metastatic breast cancer; paclitaxel; resource use