COMPARATIVE PHARMACOECONOMIC ASSESSMENT OF CDK4/6 INHIBITORS IN A LARGE BRAZILIAN PRIVATE PAYER
Author(s)
ANTONIO ELIEZER ARRAIS MOTA FILHO, MD, PhD, Clara Matias, MBA, Vicente Lima, MsC, MATEUS SILVA, MBA, THAINARA ALENCAR, MBA, Hermano A. Rocha, MPH, PhD, MD, FLAVIO IBIAPINA, MD, PhD.
Unimed Fortaleza, Fortaleza, Brazil.
Unimed Fortaleza, Fortaleza, Brazil.
OBJECTIVES: To compare real‑world costs and treatment continuation of palbociclib, ribociclib, and abemaciclib in women with breast cancer treated under Unimed Fortaleza, a large Brazilian private health plan.
METHODS: We conducted a retrospective claims analysis using the oncology database of Unimed Fortaleza. All billing records from January 2021 to December 2025 containing palbociclib, ribociclib, or abemaciclib were included. For each claim, the Brazilian real (BRL) amount was converted to USD using the corresponding monthly average USD/BRL exchange rate. For each patient-drug episode, we calculated total drug cost in USD, number of distinct months with at least one claim (“months on drug”), and cost per patient‑month in USD (total cost divided by months on drug). Descriptive statistics were generated by drug. Between‑drug differences in months on drug and cost per patient‑month were evaluated using one‑way ANOVA and pairwise Welch’s t‑tests with 95% confidence intervals (CIs). For cost per patient‑month, ANOVA was performed on log‑transformed values.
RESULTS: A total of 227 patients received at least one CDK4/6 inhibitor (52 palbociclib, 76 ribociclib, 99 abemaciclib). The mean difference in months on drug between palbociclib and abemaciclib was 4.77 months (95% CI 0.67 to 8.87; p=0.023). Mean cost per patient‑month in USD also differed (p=0.005), with palbociclib less costly (≈USD 3,800) than ribociclib (≈USD 4,200) and abemaciclib (≈USD 4,200). Cost per patient‑month favored palbociclib versus ribociclib (mean difference −USD 396; 95% CI −793 to 0; p=0.050) and versus abemaciclib (−USD 423; 95% CI −869 to 22; p=0.062), while ribociclib and abemaciclib were similar.
CONCLUSIONS: In this large Brazilian private payer, palbociclib was associated with significantly longer treatment continuation and a consistent trend toward lower cost per patient‑month in USD compared with ribociclib and abemaciclib. These findings highlight within‑class heterogeneity in economic performance and support consideration of palbociclib‑focused formulary and contracting strategies.
METHODS: We conducted a retrospective claims analysis using the oncology database of Unimed Fortaleza. All billing records from January 2021 to December 2025 containing palbociclib, ribociclib, or abemaciclib were included. For each claim, the Brazilian real (BRL) amount was converted to USD using the corresponding monthly average USD/BRL exchange rate. For each patient-drug episode, we calculated total drug cost in USD, number of distinct months with at least one claim (“months on drug”), and cost per patient‑month in USD (total cost divided by months on drug). Descriptive statistics were generated by drug. Between‑drug differences in months on drug and cost per patient‑month were evaluated using one‑way ANOVA and pairwise Welch’s t‑tests with 95% confidence intervals (CIs). For cost per patient‑month, ANOVA was performed on log‑transformed values.
RESULTS: A total of 227 patients received at least one CDK4/6 inhibitor (52 palbociclib, 76 ribociclib, 99 abemaciclib). The mean difference in months on drug between palbociclib and abemaciclib was 4.77 months (95% CI 0.67 to 8.87; p=0.023). Mean cost per patient‑month in USD also differed (p=0.005), with palbociclib less costly (≈USD 3,800) than ribociclib (≈USD 4,200) and abemaciclib (≈USD 4,200). Cost per patient‑month favored palbociclib versus ribociclib (mean difference −USD 396; 95% CI −793 to 0; p=0.050) and versus abemaciclib (−USD 423; 95% CI −869 to 22; p=0.062), while ribociclib and abemaciclib were similar.
CONCLUSIONS: In this large Brazilian private payer, palbociclib was associated with significantly longer treatment continuation and a consistent trend toward lower cost per patient‑month in USD compared with ribociclib and abemaciclib. These findings highlight within‑class heterogeneity in economic performance and support consideration of palbociclib‑focused formulary and contracting strategies.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
RWD87
Topic
Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Oncology