Pharmacoeconomic evaluation of ribociclib plus fulvestrant in second-line treatment of HR+/HER2- advanced breast cancer for postmenopausal women
10.12173/j.issn.1005-0698.202412109
- VernacularTitle:瑞波西利联合氟维司群二线治疗绝经后HR+/HER2-晚期转移性乳腺癌的药物经济学评价
- Author:
Caifeng JIA
1
;
Jie WANG
;
Sen ZHANG
;
Meiqi WANG
;
Sainan LI
;
Mingxia WANG
Author Information
1. 河北医科大学第四医院临床药理研究部(石家庄 050011)
- Publication Type:Journal Article
- Keywords:
Ribociclib;
Fulvestrant;
Advanced breast cancer;
Postmenopausal;
Pharmacoeconomic evaluation;
Cost-effectiveness analysis
- From:
Chinese Journal of Pharmacoepidemiology
2025;34(6):612-620
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the cost-effectiveness of the combination therapy of ribociclib plus fulvestrant compared to fulvestrant monotherapy as a second-line treatment for postmenopausal patients with hormone receptor-positive(HR+)/human epidermal growth factor receptor 2-negative(HER2-)advanced metastatic breast cancer from the perspective of the Chinese healthcare system.Methods A partitioned survival model was constructed based on MONALEESA-3 study data,with the model cycle of 4 weeks and the time range of 15 years.Total cost,quality-adjusted life years(QALYs)and incremental cost-effectiveness ratio(ICER)were compared between ribociclib combined with fulvestrant and fulvestrant monotherapy as a second-line treatment for postmenopausal patients with HR+/HER2-advanced metastatic breast cancer.The robustness of the models was validated through one-way sensitivity analysis and probabilistic sensitivity analysis.Results Compared with the fulvestrant monotherapy regimen,the ICER for the ribociclib combined with fulvestrant regimen was 187,958.06 yuan/QALY,which was below the willingness-to-pay(WTP)threshold of three times China's per capita gross domestic product(GDP)in 2024(287,247 yuan/QALY).The one-way sensitivity analysis revealed that the ICER was primarily influenced by the proportion of patients receiving subsequent treatments with the combination therapy or fulvestrant monotherapy,and the utility value of progression-free survival.The probabilistic sensitivity analysis showed that at a WTP threshold of three times China's per capita GDP in China in 2024(287,247 yuan/QALY),the probability of the ribociclib combination therapy being cost-effective was 100%.Conclusion In the context of the Chinese healthcare system,the combination therapy of ribociclib and fulvestrant is more cost-effective than fulvestrant monotherapy for the second-line treatment of postmenopausal patients with HR+/HER2-advanced metastatic breast cancer.
