A Time and Motion Study Comparing Subcutaneous Pembrolizumab Versus Intravenous Pembrolizumab in Combination with Chemotherapy for the Treatment of Metastatic Non-small Cell Lung Cancer

Subcutaneous (SC) formulations of oncology therapies could provide time-saving benefits for both patients and healthcare professionals (HCPs) compared with intravenous (IV) delivery. This prospective observational study, conducted alongside the MK-3475A-D77 phase 3, open-label randomized clinical trial, quantifies HCP and patient time with pembrolizumab SC versus pembrolizumab IV among patients with metastatic non-small cell lung cancer. Seventeen sites across eight countries in Europe (n = 4), South America (n = 3), and Asia (n = 1) were enrolled. Primary endpoints were active HCP time; patient time in the treatment chair, treatment room, and healthcare facility; and consumables usage. Descriptive statistics included weighted mean (WM), and a linear mixed model (LMM) was employed to explore differences in time measures between pembrolizumab SC and pembrolizumab IV per visit. Overall, 212 observations were analyzed (153 SC and 59 IV). Total active HCP time was reduced by 45.6% with SC versus IV (WM, 14.0 vs 25.8 min); HCPs spent 44.3% less time on the drug preparation process with SC versus IV (WM, 5.1 vs 9.1 min) and 46.3% less time on the drug administration process with SC versus IV (WM, 8.9 vs 16.7 min). Patient chair time was reduced by 49.6% with SC versus IV (WM, 59.0 vs 117.2 min). Patients receiving SC spent less time in the treatment room than those receiving IV (WM, 66.7 vs 126.9 min; difference – 47.4%). Exploratory LMM showed considerable between-group differences for active HCP time and patient time in the treatment chair and treatment room. Pembrolizumab SC substantially reduces active HCP time and patient chair time versus pembrolizumab IV. Time liberated for HCPs could be reallocated toward additional patient care activities, while optimized chair utilization could improve overall healthcare efficiency.