Subcutaneous Immunotherapy: Patient Convenience or Patent Hopping?

April 2, 2026. A new article published from BG Lab in Journal of Clinical Oncology questions if new approvals of subcutaneous formulations of immunotherapy drugs are truly for patients’ convenience or simply a strategy of patent hopping. This paper was led by Dr. Laure-Anne Teuwen from BG Lab with senior author Dr. Bishal Gyawali and co-author Dr. Rachel Riechelmann.

Recently, subcutaneous formulations of immunotherapies such as pembrolizumab have been approved. These reformulations are promoted to offer greater convenience for patients in relation to comfort, shorter administration times, and easier outpatient care versus the current available intravenous formulations.

In this paper, they authors question the cost and clinical implications of this presumed convenience. They argue that these new formulations reflect “patent hopping” more than patient convenience, whereby pharmaceutical companies promote a reformulation to extend the manufacturer’s drug exclusivity.

This paper builds on the concept of Cost of Convenience, which Dr. Gyawali discussed in his JCO Oncology Practice commentary in 2025. In the current publication, they argue subcutaneous formulations come at a cost to equity and patient-centered care, in addition to the dubious claim of convenience. With intravenous formulations, doses can be titrated or prescribed with weight-based dosing, thus improving healthcare costs and de-escalating treatment for patients. Subcutaneous formulations do not offer this flexibility as they are at a fixed dose. This raises concerns regarding overtreating patients, increased costs for the healthcare system, and impaired equity in access to cancer drugs. Read more about de-escalating care in oncology from Dr. Gyawali’s JNCI article.

This paper also builds on the concept of Cost of Convenience, which Dr. Gyawali discussed in his JCO commentary in 2025.

Read the full article to further grasp the nuances and evidence provided for this argument! Please email us if you need access to the full text.

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