Cost-effectiveness of CDK4/6 inhibitors in HR+/HER2- metastatic breast cancer: a systematic review and meta-analysis.

Autor:	Masurkar PP; Department of Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX, USA.; Now with Amgen Inc, Thousand Oaks, CA, USA., Prajapati P; Department of Pharmacy Administration, University of Mississippi, University, MS, USA., Canedo J; Department of Pharmacy Administration, University of Mississippi, University, MS, USA., Goswami S; Department of Pharmacy Administration, University of Mississippi, University, MS, USA.; Complete Health Economics and Outcomes Solutions, LLC, Chalfont, PA, USA., Earl S; Department of Pharmacy Practice, University of Mississippi, University, MS, USA., Bhattacharya K; Department of Pharmacy Administration, University of Mississippi, University, MS, USA.; Center for Pharmaceutical Marketing and Management, University of Mississippi, University, MS, USA.
Jazyk:	angličtina
Zdroj:	Current medical research and opinion [Curr Med Res Opin] 2024 Oct; Vol. 40 (10), pp. 1753-1767. Date of Electronic Publication: 2024 Sep 21.
DOI:	10.1080/03007995.2024.2402074
Abstrakt:	Background: Cyclin-dependent kinase 4/6 (CDK 4/6) inhibitors have emerged as a significant advancement in the treatment of HR+/HER2- metastatic breast cancer (MBC). Despite the clinical efficacy of CDK 4/6 inhibitors in HR+/HER2- metastatic breast cancer, there remains a significant gap in understanding their cost-effectiveness, particularly regarding the long-term economic impact and the key drivers of costs, when used in combination with endocrine therapy. This study aims to systematically review and conduct a meta-analysis of cost-effectiveness studies evaluating CDK4/6 inhibitors in treatment of HR+/HER2- advanced breast cancer and identify key drivers of costs of CDK4/6 inhibitors in combination with endocrine therapy. Methods: A comprehensive search of PubMed and Embase was conducted to identify peer-reviewed studies from February 2015 to March 2022 reporting cost-effectiveness of CDK4/6 inhibitors in MBC treatment. Incremental net benefits (INBs) were estimated, and meta-analysis was conducted. This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results: We identified 120 articles, of which 18 were eligible for systematic review and 16 for meta-analysis. None of the three CDK4/6 inhibitors had positive INB compared to endocrine/aromatase inhibitors therapy alone. The pooled INB was estimated at -$149,266.87 (95% Confidence Interval (CI) = -$196,961.54, -$101,572.20). Conclusion: The combination of CDK4/6 inhibitors and letrozole/endocrine therapy for the treatment of postmenopausal patients with advanced HR+/HER2 - MBC was not cost-effective.
Databáze:	MEDLINE
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