A Comparison of Treatment Costs for CDK4/6 Inhibitors in Patients With Hormone Receptor-Positive Human Epidermal Growth Factor Receptor 2-Negative HR+/HER2-: Early Breast Cancer (EBC) in Sweden
Author(s)
Aglaia Schiza, MD1, Manik Kalra, MPharm2, Ilia Ferrusi, PhD3, Teddy Saliba, MD3, Petter Foss, MPharm4, Varun Agarwal, M.A. Economics5, Kavita Rodha, MPharm6, Subhajit Gupta, MSc5, Andrii Danyliv, PhD7.
1Department of Oncology, Uppsala University Hospital, Uppsala, Sweden, 2Novartis Pharamaceuticals UK Ltd., London, United Kingdom, 3Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, 4Novartis Pharma AG, Basel, Switzerland, 5Novartis Healthcare Pvt. Ltd, Hyderabad, India, 6Novartis Ireland Limited, Dublin, Ireland, 7Novartis, Basel, Switzerland.
1Department of Oncology, Uppsala University Hospital, Uppsala, Sweden, 2Novartis Pharamaceuticals UK Ltd., London, United Kingdom, 3Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA, 4Novartis Pharma AG, Basel, Switzerland, 5Novartis Healthcare Pvt. Ltd, Hyderabad, India, 6Novartis Ireland Limited, Dublin, Ireland, 7Novartis, Basel, Switzerland.
OBJECTIVES: Ribociclib and abemaciclib, in combination with endocrine therapy, are indicated as adjuvant treatments for reducing the risk of recurrence in patients with HR+/HER2− EBC. Differences between these treatments include duration of therapy (ribociclib: 3 years; abemaciclib: 2 years), dosing regimen (ribociclib: 3-weeks-on/1-week-off in 28-day cycle; abemaciclib: 28 consecutive days), and pricing model (ribociclib: linear; abemaciclib: flat). Here, we estimate treatment cost of adjuvant ribociclib vs abemaciclib for patients with EBC in Sweden, accounting for relative dose intensity (RDI) and reported mean time on treatment (ToT).
METHODS: Model parameters were derived from published clinical trial data, regulatory documents, and publicly available sources in Sweden. Inputs included mean ToT (ribociclib, 26.5 months; abemaciclib, 19.25 months), prescribed dose adjusted for RDI, and cost per 28-day pack in Swedish kronor (kr). Pricing models of each drug were incorporated into the calculations, with ribociclib linear pricing allowing for reduced price with reduced dosing, while for abemaciclib flat pricing, drug costs remain fixed, regardless of dose reductions. Ribociclib RDI was 83.4%, and abemaciclib RDI was estimated at 100% based on submission to NICE and the Swedish Dental and Pharmaceutical Benefits Agency.
RESULTS: Cost per treatment cycle (28-days) was 14,574 kr for ribociclib, and 21,845 kr for abemaciclib. Total treatment cost was 350,188 kr for 3-year adjuvant ribociclib and 457,206 kr for 2-year adjuvant abemaciclib. Ribociclib treatment cost savings was estimated at 107,018 kr per patient (23% savings relative to abemaciclib).
CONCLUSIONS: An RDI-adjusted modeling assessment found 3-year adjuvant ribociclib treatment for patients with HR+/HER2− EBC in Sweden was less costly vs 2-year abemaciclib. Cost savings with ribociclib may be attributable to dosing regimen and impact of linear pricing. These findings can help further elucidate overall healthcare costs of adjuvant ribociclib vs abemaciclib and may be considered alongside efficacy and safety in clinical decision making.
METHODS: Model parameters were derived from published clinical trial data, regulatory documents, and publicly available sources in Sweden. Inputs included mean ToT (ribociclib, 26.5 months; abemaciclib, 19.25 months), prescribed dose adjusted for RDI, and cost per 28-day pack in Swedish kronor (kr). Pricing models of each drug were incorporated into the calculations, with ribociclib linear pricing allowing for reduced price with reduced dosing, while for abemaciclib flat pricing, drug costs remain fixed, regardless of dose reductions. Ribociclib RDI was 83.4%, and abemaciclib RDI was estimated at 100% based on submission to NICE and the Swedish Dental and Pharmaceutical Benefits Agency.
RESULTS: Cost per treatment cycle (28-days) was 14,574 kr for ribociclib, and 21,845 kr for abemaciclib. Total treatment cost was 350,188 kr for 3-year adjuvant ribociclib and 457,206 kr for 2-year adjuvant abemaciclib. Ribociclib treatment cost savings was estimated at 107,018 kr per patient (23% savings relative to abemaciclib).
CONCLUSIONS: An RDI-adjusted modeling assessment found 3-year adjuvant ribociclib treatment for patients with HR+/HER2− EBC in Sweden was less costly vs 2-year abemaciclib. Cost savings with ribociclib may be attributable to dosing regimen and impact of linear pricing. These findings can help further elucidate overall healthcare costs of adjuvant ribociclib vs abemaciclib and may be considered alongside efficacy and safety in clinical decision making.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EE6
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
Oncology