Giorgio Lorenzo Colombo, Maria Chiara Valentino, Alessandra Fabi, Maria Vittoria Dieci, Mauro Caruggi, Giacomo Matteo Bruno, Gloria Lombardi, Sergio Di Matteo
{"title":"Palbociclib + Fulvestrant与Ribociclib + Fulvestrant和Abemaciclib + Fulvestrant在意大利治疗内分泌耐药晚期或转移性乳腺癌的经济评价","authors":"Giorgio Lorenzo Colombo, Maria Chiara Valentino, Alessandra Fabi, Maria Vittoria Dieci, Mauro Caruggi, Giacomo Matteo Bruno, Gloria Lombardi, Sergio Di Matteo","doi":"10.2147/TCRM.S391769","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Material and methods: </strong>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).</p><p><strong>Results: </strong>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 €305 (lifetime) when PAL is compared with RIB; for PAL vs ABM a saving of €243 (lifetime) in a conservative scenario. Results of a budget impact analysis showed a potential savings of €319,563 for PAL vs RIB and €297,544 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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":2,"journal":{"name":"ACS Applied Bio Materials","volume":null,"pages":null},"PeriodicalIF":4.6000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/58/33/tcrm-19-301.PMC10066701.pdf","citationCount":"1","resultStr":"{\"title\":\"Economic Evaluation for Palbociclib Plus Fulvestrant vs Ribociclib Plus Fulvestrant and Abemaciclib Plus Fulvestrant in Endocrine-Resistant Advanced or Metastatic Breast Cancer in Italy.\",\"authors\":\"Giorgio Lorenzo Colombo, Maria Chiara Valentino, Alessandra Fabi, Maria Vittoria Dieci, Mauro Caruggi, Giacomo Matteo Bruno, Gloria Lombardi, Sergio Di Matteo\",\"doi\":\"10.2147/TCRM.S391769\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Material and methods: </strong>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).</p><p><strong>Results: </strong>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 €305 (lifetime) when PAL is compared with RIB; for PAL vs ABM a saving of €243 (lifetime) in a conservative scenario. Results of a budget impact analysis showed a potential savings of €319,563 for PAL vs RIB and €297,544 for PAL vs ABM. 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引用次数: 1
摘要
背景:迄今为止，在意大利还没有研究评估帕博西尼(PAL) +氟维司汀(FUL)与ribociclib (RIB) + FUL和abemaciclib (ABM) + FUL的成本效益。在意大利进行了一项成本-效果分析，比较了三种周期蛋白依赖性4/6激酶抑制剂联合内分泌疗法治疗绝经后HR+、HER2-晚期或转移性乳腺癌的妇女。材料和方法:为了评估PAL + FUL与RIB + FUL和ABM + FUL的成本效益，考虑到三种CDK4/6抑制剂在总生存期(OS)方面具有相同的有效性，在保守的情况下进行了成本最小化(MAIC, Rugo等人2021)。与所有治疗相关的不良事件(ae)来自临床试验。考虑到生活质量(QoL)数据，进行了特别分析来估计成本效益(Lloyd et al . 2006)。结果:成本最小化的输入是药物、就诊和检查、AE监测和最佳支持护理(BSC)在进展状态前，活动和BSC在生命的最后两周的进展和终末期。考虑到PAL、RIB和ABM在疗效方面的可比性，该分析显示PAL在一生中节省了轻微的经济成本。结果显示，PAL与RIB相比，每位患者节省了305欧元(一生);在保守情况下，PAL与ABM相比可节省243欧元(终生)。预算影响分析的结果显示，PAL与RIB相比可节省319,563欧元，PAL与ABM相比可节省297,544欧元。当考虑生活质量数据时，结果可能倾向于PAL，因为AE的影响较小，并且与较少的AE相关的生活质量的节省和改善。结论:从意大利的角度来看，与RIB+FUL和ABM+FUL相比，PAL+FUL在晚期/转移性HR+/HER2-乳腺癌的治疗中节省了成本。
Economic Evaluation for Palbociclib Plus Fulvestrant vs Ribociclib Plus Fulvestrant and Abemaciclib Plus Fulvestrant in Endocrine-Resistant Advanced or Metastatic Breast Cancer in Italy.
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 €305 (lifetime) when PAL is compared with RIB; for PAL vs ABM a saving of €243 (lifetime) in a conservative scenario. Results of a budget impact analysis showed a potential savings of €319,563 for PAL vs RIB and €297,544 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.
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