Ribociclib in hormone-receptor-positive advanced breast cancer: Establishing a value-based cost in China

The addition of ribociclib (RIB) to letrozole (LET) significantly increases progression free survival for patients with hormone-receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer (ABC). We identified the range of drug costs for which RIB could be considered cost effective from a Chinese perspective.

A discrete event simulation model was developed to model the treatment sequences among patients with ABC. Life years (LYs), quality-adjusted LYs (QALYs) and lifetime costs were estimated. Costs were estimated for Chinese health care systems. Three times the per capita gross domestic product (GDP) of China 2016 ($24,360) and three times the per capita GDP of Beijing city 2016 ($53,384) were used as the willingness-to-pay threshold. Probabilistic sensitivity analyses were performed.

In the base case analysis, RIB + LET provided an incremental survival benefit of 0.631 LYs and 0.451 QALYs. When RIB costs less than $721 or $1170 per 4 weeks, there was a nearly 90% likelihood that the incremental cost-effectiveness ratio for RIB + LET would be less than $24,360 per QALY or $53,384 per QALY, respectively.

A value-based price for the cost of RIB is $732 or $1170 per 4 weeks for China and Beijing City, respectively. Our study is helpful to inform the multilateral drug price negotiations in China that may be upcoming for RIB.