Cost-Effectiveness Analysis of Cyclin-Dependent Kinase 4/6 Inhibitor Palbociclib for Inoperable or Recurrent Breast
Toshihiro Shida1, Motoko Kaneko, Jiro Ogura
1Dept. of Pharmacy, Yamagata University Hospital.
Gan to Kagaku Ryoho. Cancer & Chemotherapy
|August 23, 2023
Summary
Palbociclib plus fulvestrant offers better outcomes for advanced breast cancer but at a high cost. This combination therapy is less cost-effective than fulvestrant alone, posing a significant economic burden.
Area of Science:
- Oncology
- Health Economics
Background:
- Palbociclib and endocrine therapy is approved for HR+/HER2- inoperable or recurrent breast cancer in Japan.
- This combination therapy presents a substantial economic burden to patients and society due to high costs.
- Assessing the cost-effectiveness of palbociclib plus fulvestrant versus fulvestrant monotherapy is crucial.
Purpose of the Study:
- To evaluate the cost-effectiveness of palbociclib plus fulvestrant compared to fulvestrant monotherapy.
- To determine the economic impact of this cotherapy for inoperable or recurrent breast cancer.
Main Methods:
- A three-state Markov model was utilized to analyze health outcomes.
- Clinical data were sourced from published randomized controlled trials.
- Cost data were collected from patient medical receipts at Yamagata University Hospital.
- Incremental Cost-Effectiveness Ratio (ICER) was calculated, with a threshold of 400,000 Yen/month.
- Markov chain Monte Carlo simulation was employed for probabilistic analysis.
Main Results:
- The acquisition cost for palbociclib and fulvestrant cotherapy was 6,209,554 JPY, versus 780,870 JPY for fulvestrant monotherapy.
- The cotherapy resulted in 25.7 months of progression-free survival, compared to 22.8 months for monotherapy.
- The ICER for the cotherapy was 1,847,721 JPY per quality-adjusted life month (QALM) gained.
Conclusions:
- Palbociclib and fulvestrant therapy demonstrates improved health outcomes compared to fulvestrant monotherapy.
- However, the cotherapy is significantly more expensive.
- The study suggests that palbociclib plus fulvestrant is less cost-effective for treating advanced breast cancer in this context.
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