Time and costs associated with preparing and administering zoledronic acid in patients with breast or prostate cancer and metastatic bone disease
This prospective time-and-motion study quantified total time and costs of intravenous administration of zoledronic acid in 68 patients with bone metastases secondary to breast (n = 42) or prostate cancer (n = 26) at 7 oncology clinics in the United States. Trained observers used stopwatches to record times for preinfusion tasks (vital signs, blood draw, and physical exam), zoledronic acid drug preparation, infusion tasks (hydration, prechemotherapy medications, chemotherapy infusion, and zoledronic acid infusion), and follow-up. The total cost included activity costs, materials costs, and facility costs. Median overall administration time was 99.8 minutes (breast cancer, 101.3 minutes; prostate cancer, 98.4 minutes), including 60.0 minutes among patients with no chemotherapy (n = 39) and 139.9 minutes among chemotherapy recipients (n = 29), largely due to 67.9 minutes for chemotherapy infusion. The overall median cost was $1,880 (no chemotherapy, $1,184; chemotherapy, $3,784). Intravenous zoledronic acid therapy for bone metastases is associated with a substantial time and cost burden in the United States.