Avaliação econômica do uso de ribociclibe no tratamento de câncer de mama receptor hormonal positivo (HR+) e receptor de fator de crescimento epidérmico humano-2 negativo (HER2−) localmente avançado ou metastático: uma revisão sistemática

Abstract

Hormone receptor-positive (HR+) and human epidermal growth factor receptor 2-negative (HER2-) breast cancer is the most common molecular subtype. Cyclin-dependent kinase (CDK) 4/6 inhibitors are a new class of targeted agents recommended for treatment of this subtype. Ribociclib is the representative of this class that presents more robust efficacy results considering the harsh outcome of overall survival. To investigate the cost-effectiveness of ribociclib in the treatment of patients with HR+/HER2- locally advanced or metastatic breast cancer through a systematic review of the literature. This review was conducted following Cochrane recommendations and ISPOR's CiCERO guide. The writing followed PRISMA guidelines. The searches were carried out in 8 databases. The methodology and quality of the report were assessed using the ECOBIAS checklist and the CHEERS checklist. 24 economic evaluations were included. The Markov and Partitioned Survival models, with a lifetime horizon and cycle duration of 4 weeks, were the most used. Ribociclib was considered cost-effective in 8 studies, cost-saving in 5 studies and not cost-effective in the remaining studies. Ribociclib was considered more cost-effective, and dominant compared to palbociclib. Current evidence indicates that the use of ribociclib is clinically beneficial and can be considered a cost-effective intervention for the treatment of HR+ HER2- locally advanced or metastatic breast cancer depending on the WTP in each country.