Pharmacoeconomic analysis of using cyclin-dependent kinase 4 and 6 inhibitors in the first line treatment of HR-positive HER2-negative advanced breast cancer

Avxentyev, N. A.; Lubennikova, E. V.; Frolov, M. Yu.

doi:10.17749/2070-4909.2019.12.4.279-290

Cited by 3 publications

(9 citation statements)

References 8 publications

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“…The results of the study were found to be in line with what emerged from the present work, as the comparison between the three CDK4/6i, PAL was found to be the most cost-effective. Furthermore, even in the study conducted by Avxentyev et al, 33 the use of PAL versus RIB in the Russian population was found to be the most cost-effective treatment option for postmenopausal HR+/HER2- patients with locally advanced MBC.…”

Section: Discussionmentioning

confidence: 84%

Economic Evaluation for Palbociclib Plus Fulvestrant vs Ribociclib Plus Fulvestrant and Abemaciclib Plus Fulvestrant in Endocrine-Resistant Advanced or Metastatic Breast Cancer in Italy

Colombo¹,

Valentino²,

Fabi³

et al. 2023

TCRM

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Background To date, no study evaluated the cost-effectiveness of palbociclib (PAL) plus fulvestrant (FUL) vs ribociclib (RIB) plus FUL and abemaciclib (ABM) plus FUL in Italy. Cost-effectiveness analysis comparing the three cyclin-dependent 4/6 kinase inhibitors in combination with endocrine therapies for the management of postmenopausal women with HR+, HER2- advanced or metastatic breast cancer in Italy was developed. Material and Methods To assess the cost-effectiveness of PAL plus FUL vs RIB plus FUL and ABM plus FUL, a cost-minimization has been carried out with a conservative scenario considering three CDK4/6 inhibitors with equal effectiveness in terms of overall survival (OS) (MAIC, Rugo et al 2021). Adverse events (AEs) associated with all therapies were obtained from clinical trials. Ad-hoc analysis was performed to estimate the cost-effectiveness considering the quality-of-life (QoL) data (Lloyd et al 2006). Results Cost-minimization inputs were drugs, visits and exams, AE monitoring and best supportive care (BSC) before the progression state, active and BSC in the progression and terminal phase of the last two weeks of life. Given the comparability of PAL, RIB and ABM in terms of efficacy, this analysis demonstrated slight economic savings over a lifetime for PAL. Results showed saving per patient of €305 (lifetime) when PAL is compared with RIB; for PAL vs ABM a saving of €243 (lifetime) in a conservative scenario. Results of a budget impact analysis showed a potential savings of €319,563 for PAL vs RIB and €297,544 for PAL vs ABM. When QoL data were considered, results may favor PAL due to the lower impact of AE with savings and improvement in the QoL related to fewer AE. Conclusion From the Italian perspective, a cost-saving profile associated with the use of PAL+FUL for the management of advanced/metastatic HR+/HER2- breast cancer compared to RIB+FUL and ABM+FUL emerged.

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Section: Discussionmentioning

confidence: 84%

Economic Evaluation for Palbociclib Plus Fulvestrant vs Ribociclib Plus Fulvestrant and Abemaciclib Plus Fulvestrant in Endocrine-Resistant Advanced or Metastatic Breast Cancer in Italy

Colombo¹,

Valentino²,

Fabi³

et al. 2023

TCRM

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“…Table 2 summarizes the methodology of BIA studies. Six out of 17 studies included the budget impact model [26,28,30,[35][36][37], five Markov studies [29,33,38,41,42], two cohort-based studies [34,39], and other studies based on health-state modeling [27], health economic model (HEM) [32], and spread-sheet [31], and one study did not state it clearly [40]. All studies expressed their time horizon between 1 and 5 years, and four studies used lifetime [32,33,38,42].…”

Section: Methodology Of Included Studiesmentioning

confidence: 99%

“…Table 1 shows the general characteristics of the BIAs included in the study. Among them, about half (n = 8) of the studies were conducted in Europe [26][27][28][29][30][31][32][33], three in the United States [34][35][36], three in Asia [37][38][39], two in Russia [40,41], and one in Australia [42]. BIAs were performed in the period 2004-2021.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…All studies, except for one case based on real-world data [27], were based on modeling. Nine studies only evaluated the budget impact of anti-BC interventions, eight modelbased studies evaluated the cost-effectiveness of the drug and two Russian studies in the form of cost-minimization [40,41]. Nine studies dealt with the administration methods or course of treatment or the branded drug or biosimilar trastuzumab [26, 28, 30-33, 37, 38, 42], and of the other eight studies, two studies dealt with the BIA of everolimus [35,39] and two with cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) in combination with letrozole [34,41].…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Only one study did not identify the type of BC and its stage [26]. While 14 articles mentioned the BC stage (nine cases of metastatic BC or advanced BC and five cases of early stage BC) and ten articles mentioned that their target population is patients with HER-2 positive BC [26, 28, 30-33, 37, 38, 42, 43], and three articles mentioned that their target population is HER-2 negative [34,39,41]. In general, the eligible population has been mainly due to the indication of the under-research drug or the coverage of the study perspective.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Budget impact analysis of breast cancer medications: a systematic review

Mohammadnezhad

Sattarpour

Moradi

2022

J of Pharm Policy and Pract

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Background Breast cancer (BC) is the most common cancer globally among women, with 2,261,419 new cases in 2020; systemic treatment may be neo-adjuvant, adjuvant, or both. BC subtype guides the standard systemic therapy administered, which consists of endocrine therapy for all HR + tumors, trastuzumab-based HER2-directed antibody therapy plus chemotherapy for all HER2 + tumors (with endocrine therapy given in addition, if concurrent HR positivity), and chemotherapy alone for the triple-negative subtype. This study aimed to identify, evaluate, and systematically review all budget impact analyses (BIAs) of BC medications worldwide. Methods PubMed, Scopus, and Web of Science Core Collection databases were thoroughly searched up to 26th March 2022 to identify original published studies which evaluate BIA of BC medications. ISPOR Task Force guidelines were used to assess the quality of included studies. This study was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results In total, 17 BIAs were included in the study. About half of the studies were conducted in Europe. The results of the BIAs showed that most of the included BIAs are conducted from the payer’s perspective; they have different methodological frameworks for recommended chemotherapy, targeted therapy, and immunotherapy agents to treat BC. For the same medications, the results of budgetary effects are not consistent in diverse countries. Nine out of the 17 studies were focused on trastuzumab, in which the biosimilar form reduced costs, but the brand form increased costs, especially in a 52-week treatment period. Conclusion Researchers should conduct the budget impact analysis of high-value medications such as anti-tumor drugs more objectively, and the accuracy of parameters needs to be more strictly guaranteed. Furthermore, it is worthy of declaring that the budgetary impact of the same drug is not always consistent over time, so the researchers should measure access to medication in the long run.

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Cost-Effectiveness and Cost-Utility of Palbociclib versus Ribociclib in Women with Stage IV Breast Cancer: A Real-World Data Evaluation

Al-Ziftawi

Alam

Elazzazy

et al. 2022

IJERPH

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Palbociclib and ribociclib are indicated in the first-line treatment of hormonal-receptor-positive HER-2 negative (HR+/HER-2 negative) advanced breast cancer. Despite their clinical benefit, they can increase healthcare expenditure. Yet, there are no comparative pharmacoeconomic evaluations for them in developing countries, the Middle East, or Gulf countries. This study compared the cost-effectiveness of palbociclib and ribociclib in Qatar. A 10-year within-cycle-corrected Markov’s model was developed using TreeAge Pro® software. The model consisted of three main health states: progression-free (PFS), progressed-disease (PD), and death. Costs were obtained from the actual hospital settings, transition probabilities were calculated from individual-patient data, and utilities were summarized from the published literature. The incremental cost-effectiveness ratio (ICER) and the incremental cost-utility ratio (ICUR) were calculated and compared to three gross-domestic-products per capita. Deterministic and probabilistic sensitivity analyses were performed. Ribociclib dominated palbociclib in terms of costs, life-years gained, and quality-adjusted life-years gained. The conclusions remained robust in the different cases of the deterministic sensitivity analyses. Taking all combined uncertainties into account, the confidence in the base-case conclusion was approximately 60%. Therefore, in HR+/HER-2 negative stage IV breast cancer patients, the use of ribociclib is considered cost-saving compared to palbociclib.

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Pharmacoeconomic analysis of using cyclin-dependent kinase 4 and 6 inhibitors in the first line treatment of HR-positive HER2-negative advanced breast cancer

Cited by 3 publications

References 8 publications

Economic Evaluation for Palbociclib Plus Fulvestrant vs Ribociclib Plus Fulvestrant and Abemaciclib Plus Fulvestrant in Endocrine-Resistant Advanced or Metastatic Breast Cancer in Italy

Economic Evaluation for Palbociclib Plus Fulvestrant vs Ribociclib Plus Fulvestrant and Abemaciclib Plus Fulvestrant in Endocrine-Resistant Advanced or Metastatic Breast Cancer in Italy

Budget impact analysis of breast cancer medications: a systematic review

Cost-Effectiveness and Cost-Utility of Palbociclib versus Ribociclib in Women with Stage IV Breast Cancer: A Real-World Data Evaluation

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