Cost-effectiveness Analysis of Ribociclib plus Letrozole versus Palbociclib plus Letrozole in the United Kingdom

Suri, Gaurav; Chandiwana, David; Lee, Adam F.; Mistry, Rohit

doi:10.36469/9725

Cited by 12 publications

(25 citation statements)

References 23 publications

(25 reference statements)

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“…After a comprehensive search based on the inclusion and exclusion criteria, a total of 15 articles (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)…”

Section: Results Of Literature Search and Quality Of The Included Literaturementioning

confidence: 99%

“…Eight studies were conducted in the United States (18,20,23,(25)(26)(27)(28)(29), 3 in China (24,26,28), and 1 each in Spain (15), the United Kingdom (16), Singapore (19), Canada (17), and Switzerland (21,22). One of the 14 studies did not describe the study perspective (25), 4 s t u d i e s a d o p t e d a h e a l t h s y s t e m p e r s p e c t i v e (15,19,21,22,24), 6 studies used a health insurance payer perspective (17,18,23,26,27,29), 1 study used a society-wide perspective (20), and 2 studies used both a health system perspective and a health insurance payer perspective (16,28). Study types included cost-effectiveness analysis (CEA) and/ or cost-utility analysis (CUA).…”

Section: Basic Features Of the Enrolled Studiesmentioning

confidence: 99%

“…With poor disease progression and physical condition, these patients were eligible for CDK4/6 inhibitor treatment. One of these 14 studies did not report on the menopausal status of the target population (26), three studies were conducted in non-postmenopausal patients (19,27,28), and the remaining 10 studies evaluated the cost-effectiveness of using CDK4/6 inhibitors plus endocrine therapy in postmenopausal women (15)(16)(17)(18)(20)(21)(22)(23)(24)(25)29). In terms of treatment line, two studies did not report the treatment line (18,25), and only three studies assessed the cost-effectiveness of CDK4/6 inhibitors plus endocrine therapy for second-line treatment in target populations (20,26,29).…”

Section: Basic Features Of the Enrolled Studiesmentioning

confidence: 99%

“…Only three of the included studies explained the reason for selecting their study time horizon, all of which were sufficiently long to capture most survival events in the target patients (15,17,19). Eight studies chose specific periods, including 10 years (18,19,26,29), 15 years (15,17), and 40 years (16,23), as time horizons, while six studies used full lifetime to simulate the costs and health outputs of patients following using CDK4/6 inhibitors (20)(21)(22)24,25,27,28). Most studies consistently discounted the costs and health outcomes consistently at 3% or 5% (15,(17)(18)(19)(20)(23)(24)(25)(26)(27)(28)(29), except for one study that did not report a discount rate ( 16) and one study that used both 3% and 6% discount rates for costs and health outputs (21,22).…”

Section: Basic Features Of the Enrolled Studiesmentioning

confidence: 99%

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Pharmacoeconomic evaluations of CDK4/6 inhibitors plus endocrine therapy for advanced hormone receptor-positive (HR+) and human epidermal growth factor receptor-2 negative (HER2−) breast cancer: a systematic review

Zhu¹,

Wang²,

Luo³

et al. 2022

Ann Transl Med

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Background: Hormone receptor-positive (HR+) and human epidermal growth factor receptor-2 negative (HER2−) breast cancer is the most common molecular subtype of breast cancer in many countries, and endocrine therapy remains a mainstay in its treatment. Cyclin-dependent kinase (CDK) 4/6 inhibitors are a new class of targeted agents administered orally that are recommended being used in combination with endocrine therapy as first and second line treatments for advanced HR+/HER2− breast cancer. However, their high prices largely hinder using these drugs in real world settings. To offer a new basis for future research, we investigated the cost-effectiveness of combinations of CDK4/6 inhibitors with endocrine therapy in the treatment of advanced HR+/HER2− breast cancer.Methods: We systematically searched several frequently used databases and identified economic evaluations published from February 2015 to April 2021. The systematic review was performed after retrieving the literatures and extracting data based on inclusion and exclusion criteria. The quality of each selected economic evaluation was assessed by the Consolidated Health Economic Evaluation Reporting Standards (CHEERS). Results:The literature search yielded 161 articles, among which fourteen studies (15 articles) with CHEER scores ranging from 58.33% to 87.50% entered the final analysis. Markov models were used in most studies. Based on the currently available data, CDK4/6 inhibitors plus endocrine therapy were less costeffective in first-or second-line treatment of patients with HR+/HER2− advanced breast cancer. However, ribociclib plus letrozole was more cost-effective than palbociclib plus letrozole in the first-line treatment of postmenopausal women. The economic impacts of CDK4/6 inhibitors plus endocrine therapy in nonpostmenopausal patients or second-line therapy cannot be fully evaluated due to the limited number of studies. The three most common factors affecting economic outcomes were the prices of CDK4/6 inhibitors, hazard ratios for progression-free survival and overall survival, and health status utility values. Discussion: CDK4/6 inhibitors plus endocrine therapy have shown significantly improved efficacy outcomes in HR+/HER2− metastatic breast cancer (mBC)/advancer breast cancer (ABC) first-line and second-line treatment for endocrine-sensitive and endocrine-resistant populations, while more potential fields including neoadjuvant and adjuvant settings are being identified to benefit a wider range of breast cancer patients. Meanwhile, risk of severe adverse events that more likely to happen in patients treated with CDK4/6 inhibitors can lead to reduced life quality and higher medical costs patients need to afford. The adverse drug reaction related cost in several economic burden studies were explored to be primarily driven

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“…After a comprehensive search based on the inclusion and exclusion criteria, a total of 15 articles (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)…”

Section: Results Of Literature Search and Quality Of The Included Literaturementioning

confidence: 99%

Section: Basic Features Of the Enrolled Studiesmentioning

confidence: 99%

Section: Basic Features Of the Enrolled Studiesmentioning

confidence: 99%

Section: Basic Features Of the Enrolled Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Pharmacoeconomic evaluations of CDK4/6 inhibitors plus endocrine therapy for advanced hormone receptor-positive (HR+) and human epidermal growth factor receptor-2 negative (HER2−) breast cancer: a systematic review

Zhu¹,

Wang²,

Luo³

et al. 2022

Ann Transl Med

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show abstract

“… 118 In addition to these findings, a study found that ribociclib plus letrozole resulted in greater cost‐savings than other CDK4/6 inhibitor‐letrozole combination making it a cost‐effective treatment for ER‐positive BC. 119 …”

Section: Cyclin‐dependent Kinase Inhibitors In Metastatic Tnbcmentioning

confidence: 99%

CDK4/6 inhibitors: A potential therapeutic approach for triple negative breast cancer

Saleh

Wilson

Holen

2021

MedComm

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Triple negative breast cancer (TNBC) cells lack expression of the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor‐2 (HER‐2). Thus, TNBC does not respond to hormone‐based therapy. TNBC is also an aggressive subtype associated with poorer prognoses compared to other breast cancers. Conventional chemotherapeutics are used to manage TNBC although systemic relapse is common with limited benefits being reported as well as adverse events being documented. Here, we discuss current therapies for TNBC in the neo‐ and adjuvant settings, as well as recent advancements in the targeting of PD‐L1‐positive tumors and inclusion of PARP inhibitors for TNBC patients with BRCA mutations. The recent development of cyclin‐dependent kinase (CDK) 4/6 inhibitors in ER‐positive breast cancers has demonstrated significant improvements in progression free survival in patients. Here, we review preclinical data of CDK 4/6 inhibitors and describe current clinical trials assessing these in TNBC disease.

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Cost-effectiveness of the addition of CDK4/6 inhibitors to standard endocrine therapy in first-line treatment of women with advanced HR+/HER2− breast cancer in Mexico

Molina-Jaimes,

Galindo-González,

Verduzco-Aguirre

et al. 2023

Clin Transl Oncol

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Cost-effectiveness Analysis of Ribociclib plus Letrozole versus Palbociclib plus Letrozole in the United Kingdom

Cited by 12 publications

References 23 publications

Pharmacoeconomic evaluations of CDK4/6 inhibitors plus endocrine therapy for advanced hormone receptor-positive (HR+) and human epidermal growth factor receptor-2 negative (HER2−) breast cancer: a systematic review

Pharmacoeconomic evaluations of CDK4/6 inhibitors plus endocrine therapy for advanced hormone receptor-positive (HR+) and human epidermal growth factor receptor-2 negative (HER2−) breast cancer: a systematic review

CDK4/6 inhibitors: A potential therapeutic approach for triple negative breast cancer

Cost-effectiveness of the addition of CDK4/6 inhibitors to standard endocrine therapy in first-line treatment of women with advanced HR+/HER2− breast cancer in Mexico

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