SOCIETAL IMPACT ASSESSMENT OF RIBOCICLIB FOR HR+/HER2- ADVANCED BREAST CANCER: INTEGRATING HUMAN CAPITAL AND UNPAID WORK VALUATION USING INPUT-OUTPUT ANALYSIS
Author(s)
Omar Maoujoud, PhD, MD1, sanaa haouraji, Msc2;
1Resarch team of Pharmacoeconomics & Pharmacoepidemiology, Moroccan Society of health economics (SMEPS), Facuty of Medicine, Mohamed V university, Rabat, Morocco, 2EOS Executive Lab, Casablanca, Morocco
1Resarch team of Pharmacoeconomics & Pharmacoepidemiology, Moroccan Society of health economics (SMEPS), Facuty of Medicine, Mohamed V university, Rabat, Morocco, 2EOS Executive Lab, Casablanca, Morocco
OBJECTIVES: Conventional health economic evaluations may underestimate oncology treatment value in settings with low female labor force participation rates (LFPR), as they typically exclude non-market productivity. This study quantified the societal impact of ribociclib for first-line HR+/HER2- metastatic breast cancer in Morocco using an integrated framework capturing market productivity, unpaid domestic work, and macroeconomic spillovers
METHODS: A societal impact model was constructed with three analytical components: (1) Human Capital approach estimating market productivity losses using gender-specific earnings data (annual salary: $6,225; HCP 2023); (2) replacement cost valuation of unpaid domestic work from national Time-Use Survey data ($6,008/year); and (3) Leontief Input-Output modeling with Type II multipliers (1.80) to capture indirect and induced economic effects. Overall survival benefit was derived from MONALEESA-2 (median OS gain: 12.5 months; HR=0.76, 95%CI: 0.63-0.93). Eligible population (n=2,440/year) was estimated from national cancer registry applying stage distribution and receptor status. Three reimbursement scenarios were projected over 2026-2030. Parameter uncertainty was assessed through probabilistic sensitivity analysis (PSA; 1,000 Monte Carlo simulations) and one-way deterministic sensitivity analysis (DSA)
RESULTS: Base case analysis estimated cumulative societal impact of $41.2 million over 5 years (3,050 patients). Per-patient societal value was $13,500, comprising direct productivity gains ($7,500; 55.6%) and indirect macroeconomic effects ($6,000; 44.4%). Unpaid domestic work accounted for 83.5% of direct impact, consistent with Morocco's female LFPR of 19.1%. PSA demonstrated 96.3% probability of exceeding $20 million (95%CI: $19.0-56.9 million). DSA identified treatment access as the dominant parameter (range: $13.1-105.8 million). Scenario analysis yielded $20.5 million (conservative) to $61.5 million (optimistic)
CONCLUSIONS: Ribociclib generates substantial societal value when non-market productivity is incorporated into economic evaluation. Integrating unpaid work valuation and Input-Output multipliers provides a more comprehensive assessment of treatment value, particularly relevant for HTA decision-making in contexts where conventional labor market metrics underrepresent women's economic contributions
METHODS: A societal impact model was constructed with three analytical components: (1) Human Capital approach estimating market productivity losses using gender-specific earnings data (annual salary: $6,225; HCP 2023); (2) replacement cost valuation of unpaid domestic work from national Time-Use Survey data ($6,008/year); and (3) Leontief Input-Output modeling with Type II multipliers (1.80) to capture indirect and induced economic effects. Overall survival benefit was derived from MONALEESA-2 (median OS gain: 12.5 months; HR=0.76, 95%CI: 0.63-0.93). Eligible population (n=2,440/year) was estimated from national cancer registry applying stage distribution and receptor status. Three reimbursement scenarios were projected over 2026-2030. Parameter uncertainty was assessed through probabilistic sensitivity analysis (PSA; 1,000 Monte Carlo simulations) and one-way deterministic sensitivity analysis (DSA)
RESULTS: Base case analysis estimated cumulative societal impact of $41.2 million over 5 years (3,050 patients). Per-patient societal value was $13,500, comprising direct productivity gains ($7,500; 55.6%) and indirect macroeconomic effects ($6,000; 44.4%). Unpaid domestic work accounted for 83.5% of direct impact, consistent with Morocco's female LFPR of 19.1%. PSA demonstrated 96.3% probability of exceeding $20 million (95%CI: $19.0-56.9 million). DSA identified treatment access as the dominant parameter (range: $13.1-105.8 million). Scenario analysis yielded $20.5 million (conservative) to $61.5 million (optimistic)
CONCLUSIONS: Ribociclib generates substantial societal value when non-market productivity is incorporated into economic evaluation. Integrating unpaid work valuation and Input-Output multipliers provides a more comprehensive assessment of treatment value, particularly relevant for HTA decision-making in contexts where conventional labor market metrics underrepresent women's economic contributions
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE156
Topic
Economic Evaluation
Topic Subcategory
Novel & Social Elements of Value, Work & Home Productivity - Indirect Costs
Disease
SDC: Oncology, SDC: Reproductive & Sexual Health