OBJECTIVES: The primary objective of this study was to evaluate the budget impact (BI) of palbociclib plus letrozole in ER+/HER2- post-menopausal advanced or metastatic breast cancer patients versus current treatment options (everolimus plus exemestane, bevacizumab plus capecitabin, and bevacizumsb plus paclitaxel) in Bulgaria.

METHODS: A BI model was prepared to evaluate the economic impact of palbociclib for the treatment of ER+/HER2- post-menopausal advanced or metastatic breast cancer patients in Bulgaria. For the base case analysis, the model was developed and populated with epidemiologic local data and compares the total budgetary costs of a scenario with palbociclib versus a scenario without palbociclib. The base case time horizon in the model was 5 years.

RESULTS: The BI analysis estimated that palbociclib incorporation would bring a saving of 657 047BGN in the first year of incorporation, reaching 11 167 298 BGN savings in year five. The cumulative impact over 5-year time horizon corresponds to a total saving of -26,7 million BGN.

CONCLUSIONS: The introduction of palbociclib in the Bulgarian NHIF brings significant improvements in the budget impact, with total savings of 26,7 million BGN over the five-year time horizon.