Objective: Capivasertib, a novel pan-AKT inhibitor, shows significant antitumor activity against hormone receptor-positive advanced breast cancer. However, its cost-effectiveness of this treatment remains uncertain. This study aimed to evaluate the cost-effectiveness of capivasertib plus fulvestrant versus fulvestrant alone for advanced breast cancer treatment from the perspectives of healthcare payers in the United States. Meanwhile, a experimental analysis from the perspective of China, incorporating specific assumptions, was also conducted in this study.
Methods: A partitioned survival model was constructed to project the progression of breast cancer. Overall survival (OS) and progression-free survival (PFS) data were obtained from the CAPItello-291 trial and extrapolated for long-term survival estimates. Direct medical costs and utility data were gathered. The primary outcome measure was incremental cost-utility ratio (ICUR) to evaluate the cost-effectiveness of treatment regimen. One-way sensitivity analyses (OWSA) and probabilistic sensitivity analyses (PSA) were conducted to assess the robustness of the results.
Results: The base-case analysis estimated the ICUR for capivasertib plus fulvestrant versus fulvestrant alone to be $709,647 per quality-adjusted life-year (QALY) in the US. OWSA revealed that the results were sensitive to hazard ratio of OS and the cost of capivasertib. PSA demonstrated that capivasertib plus fulvestrant exhibited a 0% probability of cost-effectiveness in the US.
Conclusion: Our finding suggests that, at its current price, capivasertib plus fulvestrant regimen is unlikely to be a cost-effective option compared to fulvestrant alone for HR-positive advanced breast cancer patients from the perspective of healthcare system in the US. For the experimental analysis based on specific assumptions from Chinese perspective, the therapy regimen was also found to lack cost-effectiveness.
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http://dx.doi.org/10.3389/fphar.2024.1495082 | DOI Listing |
Front Pharmacol
January 2025
Department of Pharmacy, Huadong Hospital, Fudan University, Shanghai, China.
ESMO Open
December 2024
Medical Oncology, Dana-Farber Cancer Institute, Boston, USA; Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, USA; Harvard Medical School, Boston, USA. Electronic address:
Mutations in the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway occur in 30%-40% of patients with advanced hormone receptor-positive/human epidermal growth factor receptor 2 (HER2)-negative (HR+/HER2-) breast cancer. For most patients, endocrine therapy with a cyclin-dependent kinase 4/6 (CDK4/6) inhibitor is the first-line treatment. Recent studies indicate that adding inavolisib, a PI3Kα inhibitor, to palbociclib/fulvestrant benefits patients with endocrine-resistant HR+/HER2- metastatic breast cancer with a PIK3CA mutation.
View Article and Find Full Text PDFPharmacol Res
December 2024
Blue Ridge Institute for Medical Research, 221 Haywood Knolls Drive, Hendersonville, NC 28791, United States. Electronic address:
Breast cancer is the most commonly diagnosed malignancy and the fifth leading cause of cancer deaths worldwide. Surgery and radiation therapy are localized therapies for early-stage and metastatic breast cancer. The management of breast cancer is determined in large part by the HER2 (human epidermal growth factor receptor 2), HR (hormone receptor), ER (estrogen receptor), and PR (progesterone receptor) status.
View Article and Find Full Text PDFPharmacoeconomics
December 2024
College of Pharmacy, University of Manitoba, 750 McDermot Avenue, Winnipeg, R3E0T5, Canada.
Breast Cancer
December 2024
Division of Endocrine & Breast Surgery, Department of Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kajii-Cho, Kamigyo-Ku, Kyoto, Japan.
Background: In Japan, despite 5 years since CGP tests were covered by insurance in 2019, low drug accessibility rates remain a critical issue. We evaluated drug accessibility in 3776 breast cancer from the C-CAT database using two criteria: the proportion first linked to PMDA-approved drugs with phase III trial evidence for breast cancer through CGP tests but not existing Companion diagnostics [CDx] (*), and the proportion first linked to PMDA-approved drugs including based on phase I and II trial evidence (**). Additionally, cases linked to investigational drugs for non-PMDA-approved drugs were counted.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!