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

被引：4

作者：

Colombo, Giorgio Lorenzo ^{[1
]}

Valentino, Maria Chiara ^{[2
]}

Fabi, Alessandra ^{[3
]}

Dieci, Maria Vittoria ^{[4
,5
]}

Caruggi, Mauro ^{[2
]}

Bruno, Giacomo Matteo ^{[2
]}

Lombardi, Gloria ^{[6
]}

Di Matteo, Sergio ^{[2
]}

机构：

[1] Univ Pavia, Dept Drug Sci, Pavia, Italy

[2] SAVE Studi Anal Valutaz Econ Srl, Hlth Econ & Outcomes Res, Milan, Italy

[3] A Gemelli IRCCS, Dept Women Children & Publ Hlth Sci, Precis Med Breast Unit, Sci Directorate, Rome, Italy

[4] Univ Padua, Dept Surg Oncol & Gastroenterol, Padua, Italy

[5] Veneto Inst Oncol IOV IRCCS, Oncol 2, Padua, Italy

[6] IQVIA Solut Italy Srl, Real World Solut, Milan, Italy

来源：

THERAPEUTICS AND CLINICAL RISK MANAGEMENT | 2023年 / 19卷

关键词：

cost effectiveness; cost-minimization; metastatic breast cancer; palbociclib; ribociclib; abemaciclib; second-line endocrine therapy; Italy;

D O I：

10.2147/TCRM.S391769

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

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 euro305 (lifetime) when PAL is compared with RIB; for PAL vs ABM a saving of euro243 (lifetime) in a conservative scenario. Results of a budget impact analysis showed a potential savings of euro319,563 for PAL vs RIB and euro297,544 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.

引用

页码：301 / 312

页数：12

共 29 条

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