BEYOND COST-EFFECTIVENESS: ESTIMATING THE SOCIAL VALUE OF PALBOCICLIB OVER ITS LIFECYCLE
Author(s)
Jacki Chou, MPP, MPL1, Marlon Graf, MPP, PhD2, Thomas Flottemesch, MS, PhD3, Beata Korytowsky, MA4, Cory Williams, MPA3, Justin Yu, PharmD4, Justin Doan, MPH, MSc, DrPH5, Joseph Biskupiak, MBA, PhD6.
1Vice President, Precision AQ, Los Angeles, CA, USA, 2Precision AQ, Los Angeles, CA, USA, 3Precision AQ, Bethesda, MD, USA, 4Pfizer, New York, NY, USA, 5Pfizer, Farragut, TN, USA, 6University of Utah, Kamas, UT, USA.
1Vice President, Precision AQ, Los Angeles, CA, USA, 2Precision AQ, Los Angeles, CA, USA, 3Precision AQ, Bethesda, MD, USA, 4Pfizer, New York, NY, USA, 5Pfizer, Farragut, TN, USA, 6University of Utah, Kamas, UT, USA.
OBJECTIVES: Ibrance® (palbociclib), a CDK4/6 inhibitor, is currently indicated for HR+/HER2- advanced/metastatic breast cancer (ABC). Cost-effectiveness analyses (CEAs) indicating CDK4/6i often fail to meet traditional willingness to pay (WTP) thresholds versus aromatase inhibitors (AIs), but they miss broader aspects of value. To better understand the comprehensive value an innovative therapy represents over its lifecycle, a social value model (SVM) was developed, accounting for reduced mortality risk and improved quality of life (QoL).
METHODS: A SVM estimates the value generated by a treatment over a specific analytic timeframe by monetizing survival and QoL benefits. Life years saved (LYS) by palbociclib are monetized using a WTP approach that considers direct clinical benefits and broader societal effects of reducing productivity losses, caregiver burden, and potential returns from revenue reinvestment. Given the extended timeframe, the model incorporates several dynamic factors: treatment costs, income growth, and approval of new indications.
RESULTS: Between 2015-44 (a 30-year lifecycle), a forecasted 6.9M will initiate palbociclib therapy in the US, resulting in 3.1M LYS. Applying value of a statistical life (VSL) estimates from HHS, this translates to $667B in direct social value. We further estimate $433B in indirect social value due to increased patient productivity ($72B) and decreased caregiver burden ($309B) as well as $52B from manufacturer reinvestment at a risk-neutral return. This results in $1.1T in total value or $157,747 per forecasted patient, in the US during palbociclib’s initial 30-year product lifecycle.
CONCLUSIONS: Traditional CEA’s often fail to capture the true value to society of novel treatments such as CDK4/6i, which target high-burden disease and are expected to have an extended lifecycle due to their innovation. A SVM, which examines direct clinical impact and broader sources of value such as productivity loss, caregiver burden and future product development, provides a more comprehensive view of value.
METHODS: A SVM estimates the value generated by a treatment over a specific analytic timeframe by monetizing survival and QoL benefits. Life years saved (LYS) by palbociclib are monetized using a WTP approach that considers direct clinical benefits and broader societal effects of reducing productivity losses, caregiver burden, and potential returns from revenue reinvestment. Given the extended timeframe, the model incorporates several dynamic factors: treatment costs, income growth, and approval of new indications.
RESULTS: Between 2015-44 (a 30-year lifecycle), a forecasted 6.9M will initiate palbociclib therapy in the US, resulting in 3.1M LYS. Applying value of a statistical life (VSL) estimates from HHS, this translates to $667B in direct social value. We further estimate $433B in indirect social value due to increased patient productivity ($72B) and decreased caregiver burden ($309B) as well as $52B from manufacturer reinvestment at a risk-neutral return. This results in $1.1T in total value or $157,747 per forecasted patient, in the US during palbociclib’s initial 30-year product lifecycle.
CONCLUSIONS: Traditional CEA’s often fail to capture the true value to society of novel treatments such as CDK4/6i, which target high-burden disease and are expected to have an extended lifecycle due to their innovation. A SVM, which examines direct clinical impact and broader sources of value such as productivity loss, caregiver burden and future product development, provides a more comprehensive view of value.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE528
Topic
Economic Evaluation
Topic Subcategory
Novel & Social Elements of Value
Disease
Oncology