Economic assessment of abemaciclib for the adjuvant treatment of luminal HER2- breast cancer from the perspective of the Spanish health system

Silvia Fenix-Caballero, Adrián Sanchez-Vegas, Emilio Jesús Alegre Del-Rey, David Epstein, Leticia Garcia-Mochon and Antonio Olry de Labry Lima ()
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Silvia Fenix-Caballero: Hospital Universitario Puerto Real
Adrián Sanchez-Vegas: Hospital Universitario Nuestra Señora de Valme
Emilio Jesús Alegre Del-Rey: Hospital Universitario Puerto Real
David Epstein: Universidad de Granada
Leticia Garcia-Mochon: Escuela Andaluza de Salud Pública (EASP)
Antonio Olry de Labry Lima: Instituto de Investigación Biosanitaria ibs. Hospitales Universitarios de Granada/Universidad de Granada

The European Journal of Health Economics, 2025, vol. 26, issue 1, No 5, 49-62

Abstract: Abstract Introduction Abemaciclib is an oral inhibitor of cyclin-dependent kinases 4 and 6 (CDK4/6). Data from the clinical trial monarchE (2023) showed improved survival from invasive disease. The aim of the present article was to conduct an economic assessment of adjuvant treatment with abemaciclib in women with luminal, HER2- and node-positive breast cancer. Methods A Markov model was constructed with four mutually exclusive health states (disease-free, local recurrence, distal recurrence and death). Analyses were based on the clinical trial monarchE which compared an intervention group (abemaciclib + hormone therapy [HT]) with HT alone. The effectiveness measure used was quality-adjusted life years (QALY), with unit costs and utilities being obtained from existing literature. The incremental cost–utility ratio (ICUR) was used to compare the two treatment strategies. Results Total costs were €98,765 and €17,935 for the abemaciclib plus HT group and the HT alone group, respectively. The health outcome was 10.076QALY for the intervention group and 9.495QALY for the control group, with the ICUR being€139,173/QALY. Conclusion Despite the significant gains of abemaciclib as adjuvant treatment in terms of progression-free survival, this treatment is not cost-effective for the Spanish National Health System at published prices. It may be cost-effective with an appropriate discount on the official price.

Keywords: Abemaciclib; Cost-effectiveness analysis; Hormone receptor-positive breast cancer (search for similar items in EconPapers)
JEL-codes: I11 (search for similar items in EconPapers)
Date: 2025
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DOI: 10.1007/s10198-024-01681-3

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