{
  "abstract": "Background\n\nBreast cancer (BC) imposes a substantial and evolving health and economic burden in China. We integrated population-level disease burden with treatment-specific economic evaluation to assess the cost-effectiveness of culmerciclib plus fulvestrant for previously treated hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer (ABC).Methods\n\nUsing Global Burden of Disease Study 2023 data, we assessed BC incidence, prevalence, mortality, disability-adjusted life-years (DALYs), and temporal trends in China. GBD estimates provided population-level context and were not direct inputs into the economic model. We then conducted a lifetime cost-effectiveness analysis from the Chinese healthcare perspective, comparing culmerciclib plus fulvestrant with placebo plus fulvestrant for previously treated HR+/HER2- ABC based on randomized Phase III trial efficacy. Outcomes included costs, life-years, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs). The willingness-to-pay (WTP) threshold was $26,896/QALY, equivalent to twice China's per-capita gross domestic product.Results\n\nIn 2023, BC caused 342,725 incident cases, 3,496,338 prevalent cases, 76,589 deaths, and 2,458,481 DALYs in China. From 1990 to 2023, the age-standardized rates (ASRs) of incidence and prevalence increased, whereas the ASRs of mortality and DALY decreased. All four ASRs rose during 2020-2023. In the base-case analysis, culmerciclib plus fulvestrant provided an additional 0.90 QALYs at an incremental cost of $34,150.43 compared with placebo plus fulvestrant, resulting in an ICER of $37,886.61/QALY. At the prespecified WTP threshold, the probability of culmerciclib plus fulvestrant being cost-effective was 2.7%. Culmerciclib price was the main uncertainty driver. A 25% reduction in the price of culmerciclib lowered the ICER to $26,677.03/QALY.Conclusions\n\nAgainst the background of a substantial and evolving BC burden in China, culmerciclib plus fulvestrant provides additional health benefits but is unlikely to be cost-effective compared with placebo plus fulvestrant for previously treated HR+/HER2- ABC at its current price. Integrating population-level disease burden with treatment-specific economic evidence provides complementary information for healthcare resource allocation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiation Oncology, Zhuji Affiliated Hospital of Wenzhou Medical University, Shaoxing, Zhejiang, People's Republic of China.",
    "Department of Quality Management, Zhuji Blood Bank, Shaoxing, Zhejiang, People's Republic of China.",
    "Department of Medical Oncology, Zhuji Affiliated Hospital of Wenzhou Medical University, Shaoxing, Zhejiang, People's Republic of China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Feng Xuan"
    },
    {
      "affs": [
        1
      ],
      "name": "Mengjuan Ding"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhaoqi Qiu"
    },
    {
      "affs": [
        0
      ],
      "name": "Liejiong Wang"
    },
    {
      "affs": [
        2
      ],
      "name": "Haiyan Xu"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/7qp178npef396.bib",
  "cited_by": 0,
  "doi": "10.2147/ijwh.s636398",
  "fulltext_url": "https://europepmc.org/articles/PMC13679583",
  "id": "7qp178npef396",
  "issns": [
    "1179-1411"
  ],
  "landing_url": "https://europepmc.org/article/MED/42899221",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2002|Health Systems, Economic Evaluations, Quality of Life"
    ]
  ],
  "openalex": "W7221861744",
  "pdf_url": "https://europepmc.org/articles/PMC13679583?pdf=render",
  "pmcid": "PMC13679583",
  "pmid": "42899221",
  "published": "2026-10-15",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/7qp178npef396.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:33Z",
      "native_id": "MED:42899221",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42899221"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Cost-Effectiveness of Culmerciclib Plus Fulvestrant for Previously Treated HR-Positive/HER2-Negative Advanced Breast Cancer in China: An Integrated GBD 2023 Analysis.",
  "title_text": "Cost-Effectiveness of Culmerciclib Plus Fulvestrant for Previously Treated HR-Positive/HER2-Negative Advanced Breast Cancer in China: An Integrated GBD 2023 Analysis.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:33Z",
  "url": "https://research.draconitic.com/paper/7qp178npef396",
  "venue": "International journal of women's health",
  "versions": []
}