A Systematic Review of Economic Evaluation of CDK4/6 Inhibitors in HR+/HER2- Advanced Breast Cancer

摘要/Abstract

摘要：

Objective To review the domestic and foreign economic studies on CDK4/6 inhibitors in first-line or second-line treatment of HR+/HER2- advanced breast cancer, and to analyze the main methodologies and research results. Methods Systematic literature review was used to search PubMed, EMBASE, Cochrane Library, CNKI, CBM, and Wanfang database. The incremental cost-effectiveness ratio was taken as the main outcome index, and all pharmacoeconomic evaluations with CDK4/6 inhibitors as intervention measures were included, such as Palbociclib, Ribociclib, and Abemaciclib. According to the Quality of Health Economic Studies Instrument, the quality of the included articles was evaluated, and then the included literature was analyzed. Results and Conclusion A total of 16 pharmacoeconomic evaluation studies were included, mainly from the perspective of national healthcare systems or third-party payers. Only 2 studies focused on second-line treatment, and the remaining treatment levels were first-line treatment. In terms of model structure, 7 studies adopted the Markov model, 6 studies adopted the PSM model, and 3 studies adopted the DES model. The basic analysis results showed that CDK4/6 inhibitor combined with endocrine regimen was not economical compared with endocrine alone regimen when the threshold was the conventional willingness to pay (WTP) value of each country. The uncertainty analysis included deterministic sensitivity analysis and probability sensitivity analysis. The included studies are all Cost-Utility Analysis with high-quality evaluation, which can provide evidence support for health-related decision-makers in decision-making. It can also provide methodological reference for the economic evaluation of other targeted drugs.

关键词:

CDK4/6 inhibitor, breast cancer, cost-effectiveness analysis, systematic literature review

Abstract: Objective To review the domestic and foreign economic studies on CDK4/6 inhibitors in first-line or second-line treatment of HR+/HER2- advanced breast cancer, and to analyze the main methodologies and research results. Methods Systematic literature review was used to search PubMed, EMBASE, Cochrane Library, CNKI, CBM, and Wanfang database. The incremental cost-effectiveness ratio was taken as the main outcome index, and all pharmacoeconomic evaluations with CDK4/6 inhibitors as intervention measures were included, such as Palbociclib, Ribociclib, and Abemaciclib. According to the Quality of Health Economic Studies Instrument, the quality of the included articles was evaluated, and then the included literature was analyzed. Results and Conclusion A total of 16 pharmacoeconomic evaluation studies were included, mainly from the perspective of national healthcare systems or third-party payers. Only 2 studies focused on second-line treatment, and the remaining treatment levels were first-line treatment. In terms of model structure, 7 studies adopted the Markov model, 6 studies adopted the PSM model, and 3 studies adopted the DES model. The basic analysis results showed that CDK4/6 inhibitor combined with endocrine regimen was not economical compared with endocrine alone regimen when the threshold was the conventional willingness to pay (WTP) value of each country. The uncertainty analysis included deterministic sensitivity analysis and probability sensitivity analysis. The included studies are all Cost-Utility Analysis with high-quality evaluation, which can provide evidence support for health-related decision-makers in decision-making. It can also provide methodological reference for the economic evaluation of other targeted drugs.

Key words:

CDK4/6 inhibitor, breast cancer, cost-effectiveness analysis, systematic literature review

Wang Fang, Zhang Fang, Li Xue, Dong Li.

A Systematic Review of Economic Evaluation of CDK4/6 Inhibitors in HR+/HER2- Advanced Breast Cancer

[J]. 亚洲社会药学, 2022, 17(4): 351-366.

Wang Fang, Zhang Fang, Li Xue, Dong Li. A Systematic Review of Economic Evaluation of CDK4/6 Inhibitors in HR+/HER2- Advanced Breast Cancer[J]. Asian Journal of Social Pharmacy, 2022, 17(4): 351-366.

亚洲社会药学