OBJECTIVES

Prevalence of breast cancer in Egypt is about 18.9% of total cancer cases. This prevalence lead to increase economic burden on payers to satisfy different treatment needs, and when appearance of new lines of treatment the need was raised for sequencing strategy for enhancing patient outcomes including (quality of life – economic value – clinical effectiveness) and efficient resource management to treat more patients.

The objective of this study is to determine sequencing strategy impact on using( Palbociclib ) prior to (Ribociclib) as line of treatment to enhance patient outcomes & resource utilization for in combination with hormonal therapy to treat hormonal receptor-positive,( HR + HER2-negative )metastatic breast cancers.

METHODS

A Markov model was applied with three health states. . Utility data were incorporated in the model to make adjusted results. Costs used were the local ones according to the local lists of Egypt. Discounting was applied at 3.5% annually both on costs and benefits.

The results obtained were in term of and number of QALYs. (Quality adjusted life years). Robustness of our findings was checked using sensitivity analyses.

Efficacy data obtained by conducting indirect network meta-analysis for all available clinical studies

RESULTS

: During the three-year time horizon, the total cumulative QALY gained for (Palbociclib + Letrozole) was (1.58) QALY. The total QALY gained for (Ribociclib +Letrozole) was a (0.43 QALY. ) The difference is 0.56 in QALY. Sensitivity analyses show no effect on results.

CONCLUSIONS

The result of the study suggests that the impact of Palbociclib for enhancing patient outcomes is dominating.

Using line of Palbociclib prior to (Ribociclib ) for treating metastatic breast cancer may have dominant effect on patient outcomes as a treatment strategy one of the challenges facing such kind of analysis is availability of survival data and importance of selection of appropriate patient criteria from different stake holders prospective .