Give subcutaneous immunotherapy in community clinics and at home
Under-the-skin versions of atezolizumab, nivolumab and pembrolizumab take minutes rather than an hour and need no infusion chair, so they can be given by a nurse near home, cutting facility fees and travel.
Overview
The FDA approved subcutaneous atezolizumab (2024), nivolumab (2024) and pembrolizumab (2025), each with hyaluronidase to allow a large-volume injection over a few minutes. The clinical benefit is equivalent; the economic benefit depends on where the injection is given. Delivered in a community clinic or by a home-visiting nurse, the injection avoids hospital facility fees, infusion-suite capacity and long journeys. Payment rules that require an infusion setting, and the drug's Part B status, currently blunt the saving.
- Fragmented care and guideline gaps · Patients fall between specialists, wait for referrals and often do not get the treatment guidelines say they should.
- Prices and value · New cancer drugs routinely cost over $150,000 a year, often for months of benefit. Systems cannot afford them and patients go bankrupt.
- Not enough oncologists, nurses, pathologists, physicists · The number of people with cancer is rising faster than the workforce trained to treat them.
- Most of the world has almost no cancer care · Seven in ten cancer deaths happen in low- and middle-income countries, where radiotherapy, pathology, surgery and drugs are scarce.
Pages like this
not linked directly; found by shared links- IdeaSubscription pricing for checkpoint inhibitors: fixed national fee, unlimited use
Shares Prices and value, Nivolumab, Most of the world has almost no cancer care, Pembrolizumab.
- IdeaMake six-weekly immunotherapy the default schedule
Shares Not enough oncologists, nurses, pathologists, physicists, Fragmented care and guideline gaps, Nivolumab, Pembrolizumab.
- IdeaAn advance market commitment for PD-1 biosimilars for lower-income countries
Shares Prices and value, Nivolumab, Most of the world has almost no cancer care, Pembrolizumab.
- IdeaRestore weight-based dosing and vial sharing for immunotherapy in the label
Shares Prices and value, Nivolumab, Pembrolizumab, Immune checkpoint inhibitors.
- IdeaAutomatic price cuts when a cancer drug's approved indications and volumes expand
Shares Prices and value, Nivolumab, Pembrolizumab.
- IdeaExtended-interval immunotherapy: give checkpoint inhibitors every 8-12 weeks once stable
Shares Atezolizumab, Prices and value, Nivolumab, Pembrolizumab.
- IdeaTest one-tenth-dose immunotherapy where the full dose is unaffordable
Shares Prices and value, Nivolumab, Most of the world has almost no cancer care, Pembrolizumab.
- IdeaPublicly funded dose-reduction trials of expensive approved drugs
Shares Prices and value, Nivolumab, Pembrolizumab, Immune checkpoint inhibitors.