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, Mariana; Galindo-González, Antonio; Verduzco-Aguirre, Haydeé Cristina; Bautista-Arredondo, Sergio; Reyes-Terán, Gustavo; Soto-Perez-de-Celis, Enrique

doi:10.1007/s12094-023-03247-w

Cited by 2 publications

(3 citation statements)

References 14 publications

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“…48,49 In Mexico, only abemaciclib was found to be costeffective among CDK4/6 inhibitors for HR1/HER2-advanced breast cancer. 50 A recent study found the addition of ribociclib or palbociclib to fulvestrant for HR1/HER2-metastatic breast cancer to be cost-ineffective in India. 14 Similar to our study, a cost-effectiveness analysis from the societal Dutch perspective for HR1/HER2-EBC found abemaciclib to be cost-ineffective with an ICER of ₹5,608,450.21 ($67,159.03 USD)/QALY in the favorable scenario.…”

Section: Discussionmentioning

confidence: 99%

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Cost-Effectiveness of Adjuvant Abemaciclib and Ribociclib in High-Risk Hormone Receptor–Positive Early Breast Cancer: An Indian Perspective

Sra,

Sasi,

Batra

et al. 2024

JCO Glob Oncol

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PURPOSE Incorporating adjuvant cyclin-dependent kinase (CDK) 4/6 inhibitors abemaciclib and ribociclib along with endocrine therapy has been shown to improve invasive disease-free survival (iDFS) for hormone receptor–positive (HR+) human epidermal receptor 2–negative (HER2–) early breast cancer (EBC). This study assesses the cost-effectiveness of this strategy, along with adjuvant aromatase inhibitors from an Indian perspective. METHODS A Markov chain model evaluated the cost-effectiveness of abemaciclib and ribociclib with letrozole compared with letrozole alone for HR+/HER2– EBC from a payer perspective in India. Key measures included lifetime quality-adjusted life-years (QALY), life-years (LY), and total costs. This study explores two scenarios for effectiveness: a best-case (BC) scenario, where the benefit of CDK4/6 inhibitors in improving iDFS lasts a lifetime, and a worst-case (WC) scenario, where benefits disappear after 5 years. Probabilistic sensitivity analyses (PSA) were used to account for simulation uncertainty. RESULTS In the BC scenario, abemaciclib added 2.17 QALY and 4.96 LY, incurring ₹2,317,957.7 ($27,756.65 in US dollars [USD]) in additional costs. However, the incremental cost-effectiveness ratio (ICER) for abemaciclib exceeded India's willingness-to-pay threshold in the BC and WC scenarios. In the BC scenario, ribociclib added 0.98 QALY and 2.58 LY with added costs of ₹1,711,504.32 ($20,494.6 USD). The ICER for ribociclib also surpassed India's threshold in both scenarios. PSA showed that neither drug was cost-effective at the current market prices in either BC/WC scenario. The cost of abemaciclib and ribociclib needs to be reduced by at least 78.61% and 87.19%, respectively, to be cost-effective in the BC scenario. CONCLUSION The combination of adjuvant abemaciclib or ribociclib with letrozole is not cost-effective for HR+/HER2– EBC in India in either the BC or WC scenario.

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Section: Discussionmentioning

confidence: 99%

“…48,49 In Mexico, only abemaciclib was found to be cost-effective among CDK4/6 inhibitors for HR+/HER2– advanced breast cancer. 50 A recent study found the addition of ribociclib or palbociclib to fulvestrant for HR+/HER2– metastatic breast cancer to be cost-ineffective in India. 14…”

Section: Discussionmentioning

confidence: 99%

Cost-Effectiveness of Adjuvant Abemaciclib and Ribociclib in High-Risk Hormone Receptor–Positive Early Breast Cancer: An Indian Perspective

Sra,

Sasi,

Batra

et al. 2024

JCO Glob Oncol

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“…The issue of cost-effectiveness remains critical in oncology to ensure the sustainability of treatments. [21] The cost-effectiveness of CDK4/6 inhibitors for the treatment of HR+/ HER2− advanced breast cancer has been analyzed in some of the literature, [22][23][24][25][26][27] but the results of the literature may be different from the results of the scores in this evaluation. The reason is that the results of cost-effectiveness analysis in other countries cannot be directly applied to the selection of CDK4/6 inhibitors by Chinese medical institutions.…”

Section: Discussionmentioning

confidence: 99%

CDK4/6 inhibitors for hormone receptor-positive/human epidermal growth factor receptor 2 negative advanced breast cancer: A rapid health technology assessment

Gu,

Chen,

Xie

et al. 2023

Medicine

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Object: Based on the best available evidence, rapid health technology was used to assess 4 CDK4/6 inhibitors approved for marketing in China. This assessment aims to provide a reference basis for the selection of drugs by medical institutions in China and to promote the rational use of drugs in the clinic. Methods: Depending on the Rapid Guidelines for Drug Evaluation and Selection in Chinese Medical Institutions (the Second Edition), a percentage quantitative scoring approach was used to objectively score the pharmacological properties, efficacy, safety, economy, and other attributes of CDK4/6 inhibitors. Results: The composite score rankings were, in descending order, 78.09 points for abemaciclib, 78.04 points for palbociclib, 72.15 points for dalpiciclib, and 69.24 points for ribociclib by integrating the result of the 5 dimensions. Conclusion: Until the clinical studies, guideline recommendations, prices, and many other aspects of this assessment are updated, abemaciclib and palbociclib, which have the top 2 scores, can be used as a priority recommendation for Chinese medical institutions to select CDK4/6 inhibitors and optimize the use of the drug catalog based on the scoring results of this assessment.

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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

Cited by 2 publications

References 14 publications

Cost-Effectiveness of Adjuvant Abemaciclib and Ribociclib in High-Risk Hormone Receptor–Positive Early Breast Cancer: An Indian Perspective

Cost-Effectiveness of Adjuvant Abemaciclib and Ribociclib in High-Risk Hormone Receptor–Positive Early Breast Cancer: An Indian Perspective

CDK4/6 inhibitors for hormone receptor-positive/human epidermal growth factor receptor 2 negative advanced breast cancer: A rapid health technology assessment

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