Abraxane versus Taxol for patients with advanced breast cancer: A prospective time and motion analysis from a Chinese health care perspective

2018 Nov 23

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 ¼ 12) or Taxol (n ¼ 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 ¼ 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 reactionswith Taxol, 3 of which required a physicianvisit 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 thetime andmotion study, the mean totaltimeforAbraxane
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).
Conclusion: 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.

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