Budget impact of including ribociclib in combination with letrozole on US payer formulary: first-line treatment of post-menopausal women with HR+/HER2-advanced or metastatic breast cancer

被引:7
作者
Mistry, Rohit [1 ]
Suri, Gaurav [1 ]
Young, Kate [2 ]
Hettle, Robert [1 ]
May, Jessica R. [1 ]
Brixner, Diana [3 ]
Oderda, Gary [3 ]
Biskupiak, Joseph [3 ]
Tang, Derek [4 ]
Bhattacharyya, Devarshi [5 ]
Bhattacharyya, Subrata [5 ]
Mishra, Dinesh [5 ]
Dalal, Anand A. [4 ]
机构
[1] PAREXEL, Evergreen Bldg North,160 Euston Rd, London NW1 2DX, England
[2] PAREXEL, Horsham, PA USA
[3] Univ Utah, Dept Pharmacotherapy, Salt Lake City, UT USA
[4] Novartis, E Hanover, NJ USA
[5] Novartis, Hyderabad, India
关键词
Ribociclib; budget impact; postmenopausal women; hormone receptor-positive; human epidermal growth factor receptor 2-negative; advanced breast cancer; metastatic breast cancer; KINASE; 4/6; INHIBITOR; AROMATASE INHIBITORS; ECONOMIC BURDEN; PHASE-III; PALBOCICLIB; TRIAL; ANASTROZOLE; EVEROLIMUS; EXEMESTANE; TAMOXIFEN;
D O I
10.1080/03007995.2018.1503484
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives: The combination of a cyclin-dependent kinase 4 and 6 (CDK 4/6) inhibitor with the aromatase inhibitor letrozole is a safe and effective alternative to letrozole monotherapy for first-line hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) breast cancer. This study evaluates the budget impact of using the CDK 4/6 inhibitor ribociclib plus letrozole as a first-line treatment option for postmenopausal women with HR+/HER2- advanced breast cancer, from a United States (US) payer perspective. Methods: A cohort-based budget impact model was used to calculate the incremental cost of introducing ribociclib plus letrozole over three years for the target population. The analysis compared two scenarios: treatment options excluding or including ribociclib plus letrozole. Market shares were derived from market research and the assumption was the introduction of ribociclib plus letrozole would only displace existing CDK-based therapies. Treatment duration was based on the median time to treatment discontinuation or median progression-free survival for first-line treatment, and on clinical trial data for second- and third-line treatment. Acquisition costs were based on wholesale acquisition costs and considered co-payment. Costs for drug administration and monitoring, subsequent therapy, and relevant adverse events were included. Results: Of 1 million insured members, 263 were eligible for CDK 4/6 inhibitor treatment. Cumulative total savings with ribociclib plus letrozole were $3.01M over three years, corresponding to a cumulative incremental cost saving of $318.11 per member treated per month. Conclusions: In the US, ribociclib plus letrozole represents a cost-saving first-line treatment option for postmenopausal women with HR+/HER2- advanced breast cancer.
引用
收藏
页码:2143 / 2150
页数:8
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