PMID- 28472324
OWN - NLM
STAT- MEDLINE
DCOM- 20180507
LR  - 20220317
IS  - 1569-8041 (Electronic)
IS  - 0923-7534 (Linking)
VI  - 28
IP  - 8
DP  - 2017 Aug 1
TI  - Cost-effectiveness of palbociclib in hormone receptor-positive advanced breast 
      cancer.
PG  - 1825-1831
LID - 10.1093/annonc/mdx201 [doi]
AB  - BACKGROUND: Palbociclib (PAL), a novel small-molecule inhibitor of 
      cyclin-dependent kinases 4 and 6 for the treatment of advanced breast cancer, has 
      demonstrated significant efficacy in prolonging progression-free survival when 
      added to existing therapies. Considering the high cost of PAL, we assessed 
      cost-effectiveness of adding PAL to usual care in treatment of advanced breast 
      cancer. METHODS: We developed a discrete event simulation model to simulate time 
      to cancer progression and to compare life time clinical benefit and cost of 
      alternative treatment strategies for patients with metastatic disease from 
      societal perspective. Per approved indication, endocrine treatment naive patients 
      were assigned to PAL plus letrozole (PAL + LET) or letrozole alone (LET). 
      Patients with prior endocrine therapy were assigned to PAL plus fulvestrant (FUL) 
      (PAL + FUL) or FUL alone. The model assumptions were informed based on published 
      clinical trial data and other peer reviewed studies. We carried out one-way and 
      probabilistic sensitivity analyses to assess the robustness of our results to the 
      changes in model assumptions. RESULTS: In treatment-naive patients, the addition 
      of PAL to LET cost an estimated $768 498 per additional quality-adjusted 
      life-year (QALY) gained. The addition of PAL to FUL in patients with prior 
      endocrine therapy cost an estimated $918 166 per QALY gained. Sensitivity 
      analyses demonstrated adding PAL has a 0% chance of being cost-effectiveness in 
      either patient groups at a willingness-to-pay threshold of $100 000 per QALY. 
      CONCLUSION: From a societal perspective, PAL treatment of both patient groups 
      (with and without prior endocrine therapy) is highly unlikely to be 
      cost-effective compared with the usual care in the USA.
CI  - (c) The Author 2017. Published by Oxford University Press on behalf of the European 
      Society for Medical Oncology. All rights reserved. For permissions, please email: 
      journals.permissions@oup.com.
FAU - Mamiya, H
AU  - Mamiya H
AD  - Department of Health Policy and Management, Harvard T.H. Chan School of Public 
      Health, Boston.
FAU - Tahara, R K
AU  - Tahara RK
AD  - Department of Medical Oncology, Dana-Farber Cancer Institute, Boston.
FAU - Tolaney, S M
AU  - Tolaney SM
AD  - Department of Medical Oncology, Dana-Farber Cancer Institute, Boston.
FAU - Choudhry, N K
AU  - Choudhry NK
AD  - Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham & Women's 
      Hospital, Harvard Medical School, Boston, USA.
FAU - Najafzadeh, M
AU  - Najafzadeh M
AD  - Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham & Women's 
      Hospital, Harvard Medical School, Boston, USA.
LA  - eng
PT  - Journal Article
PT  - Validation Study
PL  - England
TA  - Ann Oncol
JT  - Annals of oncology : official journal of the European Society for Medical 
      Oncology
JID - 9007735
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Piperazines)
RN  - 0 (Pyridines)
RN  - 0 (Receptors, Estrogen)
RN  - EC 2.7.10.1 (Receptor, ErbB-2)
RN  - G9ZF61LE7G (palbociclib)
SB  - IM
MH  - Antineoplastic Agents/*therapeutic use
MH  - Breast Neoplasms/*drug therapy/metabolism/pathology
MH  - Cohort Studies
MH  - *Cost-Benefit Analysis
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Piperazines/*therapeutic use
MH  - Pyridines/*therapeutic use
MH  - Quality-Adjusted Life Years
MH  - Receptor, ErbB-2/metabolism
MH  - Receptors, Estrogen/*metabolism
OTO - NOTNLM
OT  - breast cancer
OT  - cost utility analysis
OT  - cost-effectiveness analysis
OT  - economic evaluation
OT  - palbociclib
EDAT- 2017/05/05 06:00
MHDA- 2018/05/08 06:00
CRDT- 2017/05/05 06:00
PHST- 2017/05/05 06:00 [pubmed]
PHST- 2018/05/08 06:00 [medline]
PHST- 2017/05/05 06:00 [entrez]
AID - S0923-7534(19)32144-1 [pii]
AID - 10.1093/annonc/mdx201 [doi]
PST - ppublish
SO  - Ann Oncol. 2017 Aug 1;28(8):1825-1831. doi: 10.1093/annonc/mdx201.