Cost-Effectiveness of Culmerciclib Plus Fulvestrant for Previously Treated HR-Positive/HER2-Negative Advanced Breast Cancer in China: An Integrated GBD 2023 Analysis.
- 1Department of Radiation Oncology, Zhuji Affiliated Hospital of Wenzhou Medical University, Shaoxing, Zhejiang, People's Republic of China.
- 2Department of Quality Management, Zhuji Blood Bank, Shaoxing, Zhejiang, People's Republic of China.
- 3Department of Medical Oncology, Zhuji Affiliated Hospital of Wenzhou Medical University, Shaoxing, Zhejiang, People's Republic of China.
Abstract
Background
Breast 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
Using 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
In 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
Against 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.
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BibTeX
@article{xuan2026costeffectiveness,
title = {{Cost-Effectiveness of Culmerciclib Plus Fulvestrant for Previously Treated HR-Positive/HER2-Negative Advanced Breast Cancer in China: An Integrated GBD 2023 Analysis.}},
author = {Feng Xuan and Mengjuan Ding and Zhaoqi Qiu and Liejiong Wang and Haiyan Xu},
journal = {International journal of women's health},
year = {2026},
month = oct,
doi = {10.2147/ijwh.s636398},
url = {https://europepmc.org/article/MED/42899221},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Cost-Effectiveness of Culmerciclib Plus Fulvestrant for Previously Treated HR-Positive/HER2-Negative Advanced Breast Cancer in China: An Integrated GBD 2023 Analysis.
AU - Feng Xuan
AU - Mengjuan Ding
AU - Zhaoqi Qiu
AU - Liejiong Wang
AU - Haiyan Xu
PY - 2026
DA - 2026/10/15
JO - International journal of women's health
DO - 10.2147/ijwh.s636398
UR - https://europepmc.org/article/MED/42899221
AB - Background Breast 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 Using 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 In 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 Against 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.
SN - 1179-1411
ER -