Capivasertib cost-effectiveness in treating advanced breast cancer: A US health care perspective.

IF 2.9 4区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Journal of managed care & specialty pharmacy Pub Date : 2025-09-01 DOI:10.18553/jmcp.2025.31.9.900

Chijioke Okeke, Javeria Khalid, J Douglas Thornton, Moosa Tatar

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引用次数: 0

Abstract

Background: Capivasertib has gained US Food and Drug Administration approval in combination with a hormonal-based regimen (eg, fulvestrant) for managing hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer, with results from the CapiTello-291 trial showing Capivasertib plus fulvestrant to have superior efficacy compared with fulvestrant alone.

Objective: To examine the cost-effectiveness of capivasertib plus fulvestrant vs fulvestrant alone for treating HR+/HER2- advanced breast cancer in the United States from a payer's perspective.

Methods: A Markov model of 708 participants with 3 health states (progression-free, progressive disease, death) from CapiTello-291 trial data was used to compare the costs and efficacy of the two treatment strategies on TreeAge Pro software. This model adopted a willingness-to-pay (WTP) threshold of $100,000 per quality-adjusted life-year (QALY) from a US health care perspective. A 10-year lifetime horizon with a monthly cycle length was used with a 3% discount on costs and utilities derived from previously published resources. To assess our model's uncertainty, multiple one-way sensitivity analyses and probabilistic sensitivity analyses using various distribution ranges of our model parameters were conducted.

Results: In the base model, capivasertib plus fulvestrant treatment was expected to generate an incremental 0.62 QALYs at an incremental cost of $79,117.66, which resulted in an incremental cost-effectiveness ratios of $128,283.61/QALY. Our sensitivity analysis shows that at willingness-to-pay levels of $130,000/QALY and $500,100/QALY, the likelihood of capivasertib plus fulvestrant being cost-effective compared with fulvestrant monotherapy was 50% and 100%, respectively.

Conclusions: The findings from this study suggest that adding capivasertib to fulvestrant treatment is not cost-effective when compared with fulvestrant alone, from the perspective of the US health care system. Considering the notable therapeutic impact that the inclusion of this medication in standard treatment plans can have, it is necessary to engage in more extensive talks and negotiations over the pricing of this newly approved medication.

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Capivasertib治疗晚期乳腺癌的成本效益：美国医疗保健观点

背景：Capivasertib已获得美国食品和药物管理局（fda）批准与激素治疗方案（如氟维司汀）联合治疗激素受体阳性（HR+）和人表皮生长因子受体2-阴性（HER2-）晚期乳腺癌，CapiTello-291试验的结果显示Capivasertib联合氟维司汀比单独使用氟维司汀具有更好的疗效。目的：从付款人的角度考察capivasertib联合氟维司汀与单独氟维司汀治疗HR+/HER2-晚期乳腺癌在美国的成本效益。方法：采用来自CapiTello-291试验数据的708名参与者的3种健康状态（无进展、进展性疾病、死亡）的Markov模型，比较两种治疗策略在TreeAge Pro软件上的成本和疗效。从美国医疗保健的角度来看，该模型采用了每质量调整生命年（QALY） 10万美元的支付意愿（WTP）门槛。使用10年的生命周期和每月的周期长度，并根据先前公布的资源对成本和公用事业进行3%的折扣。为了评估模型的不确定性，我们对模型参数的不同分布范围进行了多重单向灵敏度分析和概率灵敏度分析。结果：在基础模型中，capivasertib + fulvestrant治疗预计将产生0.62个增量QALY，增量成本为79,117.66美元，这导致增量成本-效果比为128,283.61美元/QALY。我们的敏感性分析显示，在13万美元/QALY和500,100美元/QALY的支付意愿水平下，capivasertib加氟维司汀与氟维司汀单药治疗相比具有成本效益的可能性分别为50%和100%。结论：从美国卫生保健系统的角度来看，本研究的结果表明，与单独使用氟维司汀相比，在氟维司汀治疗中添加capivasertib并不具有成本效益。考虑到将这种药物纳入标准治疗计划可能产生的显著治疗影响，有必要就这种新批准的药物的定价进行更广泛的会谈和谈判。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of managed care & specialty pharmacy Health Professions-Pharmacy

CiteScore

3.50

自引率

4.80%

发文量

131

期刊介绍： JMCP welcomes research studies conducted outside of the United States that are relevant to our readership. Our audience is primarily concerned with designing policies of formulary coverage, health benefit design, and pharmaceutical programs that are based on evidence from large populations of people. Studies of pharmacist interventions conducted outside the United States that have already been extensively studied within the United States and studies of small sample sizes in non-managed care environments outside of the United States (e.g., hospitals or community pharmacies) are generally of low interest to our readership. However, studies of health outcomes and costs assessed in large populations that provide evidence for formulary coverage, health benefit design, and pharmaceutical programs are of high interest to JMCP’s readership.