Cost-Effectiveness and Cost-Utility of Palbociclib versus Ribociclib in Women with Stage IV Breast Cancer: A Real-World Data Evaluation

Nour Hisham Al-Ziftawi, Mohammed Fasihul Alam, Shereen Elazzazy, Asrul Akmal Shafie, Anas Hamad and Mohamed Izham Mohamed Ibrahim ()
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Nour Hisham Al-Ziftawi: Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
Mohammed Fasihul Alam: Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
Shereen Elazzazy: Pharmacy Department, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar
Asrul Akmal Shafie: School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor 11800, Malaysia
Anas Hamad: Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
Mohamed Izham Mohamed Ibrahim: Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar

IJERPH, 2022, vol. 20, issue 1, 1-13

Abstract: Palbociclib and ribociclib are indicated in the first-line treatment of hormonal-receptor-positive HER-2 negative (HR+/HER-2 negative) advanced breast cancer. Despite their clinical benefit, they can increase healthcare expenditure. Yet, there are no comparative pharmacoeconomic evaluations for them in developing countries, the Middle East, or Gulf countries. This study compared the cost-effectiveness of palbociclib and ribociclib in Qatar. A 10-year within-cycle-corrected Markov’s model was developed using TreeAge Pro ® software. The model consisted of three main health states: progression-free (PFS), progressed-disease (PD), and death. Costs were obtained from the actual hospital settings, transition probabilities were calculated from individual-patient data, and utilities were summarized from the published literature. The incremental cost-effectiveness ratio (ICER) and the incremental cost-utility ratio (ICUR) were calculated and compared to three gross-domestic-products per capita. Deterministic and probabilistic sensitivity analyses were performed. Ribociclib dominated palbociclib in terms of costs, life-years gained, and quality-adjusted life-years gained. The conclusions remained robust in the different cases of the deterministic sensitivity analyses. Taking all combined uncertainties into account, the confidence in the base-case conclusion was approximately 60%. Therefore, in HR+/HER-2 negative stage IV breast cancer patients, the use of ribociclib is considered cost-saving compared to palbociclib.

Keywords: cyclin-dependent-kinase 4/6 inhibitors; advanced breast cancer; cost-effectiveness; cost-utility; cost-saving (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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