Cost-Utility of the CDK 4/6 Inhibitors for Postmenopausal Women With Luminal Advanced Breast Cancer in Brazil

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dc.contributor.authorMacedo, Luana Schroeder Damico Nascimento
dc.contributor.authorSilva, Aline Silveira
dc.contributor.authorFrança, Ana Cláudia Wekmuller
dc.contributor.authorMagliano, Carlos Alberto da Silva
dc.contributor.authorMeirelles, Isandra
dc.contributor.authorPadilla, Matheus Piccin
dc.contributor.authorSantos, Marisa da Silva
dc.date.accessioned2024-10-04T17:12:21Z
dc.date.available2024-10-04T17:12:21Z
dc.date.issued2022
dc.description.abstractObjectives: Several trials have demonstrated the benefit of the CDK 4/6 inhibitors for postmenopausal women with luminal advanced breast cancer. This research aims to compare the cost-utility of the CDK 4/6 inhibitors in patients with no history of resistance to endocrine therapy. Methods: A Markov model was constructed to estimate the incremental cost per quality-adjusted life-years (QALYs) of treatments from the Brazilian public health system perspective over a lifetime horizon (30 years) with 5% annual discount rate for both benefits and costs. Efficacy parameters were extracted from the pivotal studies. Costs were based on open data from the Brazilian Ministry of Health. The utilities were calculated according to the overall population preferences from a British study. Deterministic and probabilistic sensitivity analyses evaluated the robustness of the results. Results: The most cost-effective drug was ribociclib (US$50 748/QALY), followed by abemaciclib (US$64 052/QALY) and palbociclib (US$65 289/QALY). The univariate analysis showed that the incremental cost-utility ratio (ICUR) was mainly sensitive to the overall survival hazard ratio. The one thousand–probabilistic simulation showed that all ICUR values were above classical thresholds such as 1 to 3 gross domestic product (GDP) per capita per QALY. Conclusions: Even though there is no established willingness to pay threshold in Brazil, the estimated ICUR for CDK 4/6 in- hibitors is .6 times the Brazilian GDP per capita (GDP per capita = US$5694.73), which might be a barrier to their inclusion in the Brazilian public health system.
dc.identifier.citationSchroeder Damico Nascimento Macedo L, Silveira Silva A, Wekmuller França AC, Alberto da Silva Magliano C, Meirelles I, Piccin Padilla M, da Silva Santos M. Cost-Utility of the CDK 4/6 Inhibitors for Postmenopausal Women With Luminal Advanced Breast Cancer in Brazil. Value Health Reg Issues. 2022 Sep;31:47-52. doi: 10.1016/j.vhri.2022.02.006.
dc.identifier.otherDOI: 10.1016/j.vhri.2022.02.006.
dc.identifier.urihttps://dspace.inc.saude.gov.br/handle/123456789/468
dc.language.isoen
dc.publisherValue in Health Regional Issues
dc.subjectadvanced breast canceren
dc.subjectCDK 4/6 inhibitorsen
dc.subjectcost-utility analysisen
dc.subjecteconomic modelsen
dc.titleCost-Utility of the CDK 4/6 Inhibitors for Postmenopausal Women With Luminal Advanced Breast Cancer in Brazil
dc.typeArticle
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