Societal and Healthcare Costs of Post-IDFS Events Following Adjuvant Ribociclib Plus an Aromatase Inhibitor (AI) Versus AI Alone in Pre- and Postmenopausal Women with Early HR+/HER2- Breast Cancer in Canada.
6 affiliations
- 1Novartis Pharmaceuticals Canada, Montreal, QC H2Y 0C1, Canada.
- 2Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada.
- 3The Ottawa Hospital Cancer Centre, Ottawa, ON K1H 8L6, Canada.
- 4Avalere Health, Washington, DC 20005, USA.
- 5Avalere Health, 10672 Athens, Greece.
- 6Avalere Health, 3068 AV Rotterdam, The Netherlands.
Abstract
Background
Recent advancements in early breast cancer (EBC) for high-risk populations have significantly improved invasive disease-free survival (IDFS). While cost-effectiveness has been assessed, the broader societal impact of improved IDFS remains unstudied. A non-homogeneous semi-Markov model was developed to estimate total healthcare and societal costs after first-line treatment with ribociclib plus an aromatase inhibitor (AI) or, alternatively, AI alone in patients with hormone-receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) EBC.Methods
Using an incidence-based approach, the model calculated total expected annual societal costs of disease-related events after cessation of adjuvant treatment with ribociclib plus AI or AI alone for HR+/HER2- EBC. The model includes five states: IDFS, non-metastatic recurrence (NMR), distant recurrence (DR), secondary primary malignancy (SPM) and death, with a one-year cycle length, and a new cohort entering each year. Health state transition probabilities are based on a previously published cost-effectiveness model (CEM). Costs are tallied only after IDFS (after cessation of adjuvant treatment) and include direct costs of medical care as well as indirect costs related to employment, productivity, and wage loss.Results
At the 4-year NATALEE data cut-off (April 2024), ribociclib plus AI reduced the risk of an IDFS event by 28.5% versus AI alone (HR 0.715), corresponding in the model to 23% fewer non-fatal events (NMR, DR, and SPM), 18% lower mortality, 23% lower total direct costs (-$957,471,465), and 24% lower indirect costs (-$448,542,692) from the period of cessation of adjuvant therapy until death. Healthcare savings were driven primarily by fewer distant recurrences and deaths, while societal savings were largely due to reduced caregiver costs.Conclusions
Treatments that reduce disease recurrence and mortality can significantly lower societal costs and alleviate burden on the healthcare system.
Related
- Safety and treatment duration of ribociclib + nonsteroidal aromatase inhibitor in HR+/HER2- early breast cancer: a phase 3 randomized controlled trial (NATALEE).
- P017 Serial DXA Monitoring in Aromatase Inhibitor-Induced Bone Loss: A Decade of Progressive Bone Loss, Stabilisation with Bisphosphonate Therapy and Recovery Following Endocrine Therapy Cessation
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- Omega-3 fatty acids in aromatase inhibitor-associated dyslipidemia: mechanisms, clinical evidence, and future perspectives
- Scoping review of biologic and imaging markers associated with aromatase inhibitor related musculoskeletal symptoms
BibTeX
@article{soliman2026societal,
title = {{Societal and Healthcare Costs of Post-IDFS Events Following Adjuvant Ribociclib Plus an Aromatase Inhibitor (AI) Versus AI Alone in Pre- and Postmenopausal Women with Early HR+/HER2- Breast Cancer in Canada.}},
author = {Dina Soliman and Christine Brezden-Masley and Sandeep Sehdev and Natalia Sabater Anaya and Sophie Boukouvalas and Talitha Vincken},
journal = {Current oncology (Toronto, Ont.)},
year = {2026},
month = oct,
doi = {10.3390/curroncol33100595},
url = {https://europepmc.org/article/MED/42930162},
note = {CC BY},
}
RIS
TY - JOUR
TI - Societal and Healthcare Costs of Post-IDFS Events Following Adjuvant Ribociclib Plus an Aromatase Inhibitor (AI) Versus AI Alone in Pre- and Postmenopausal Women with Early HR+/HER2- Breast Cancer in Canada.
AU - Dina Soliman
AU - Christine Brezden-Masley
AU - Sandeep Sehdev
AU - Natalia Sabater Anaya
AU - Sophie Boukouvalas
AU - Talitha Vincken
PY - 2026
DA - 2026/10/01
JO - Current oncology (Toronto, Ont.)
DO - 10.3390/curroncol33100595
UR - https://europepmc.org/article/MED/42930162
AB - Background Recent advancements in early breast cancer (EBC) for high-risk populations have significantly improved invasive disease-free survival (IDFS). While cost-effectiveness has been assessed, the broader societal impact of improved IDFS remains unstudied. A non-homogeneous semi-Markov model was developed to estimate total healthcare and societal costs after first-line treatment with ribociclib plus an aromatase inhibitor (AI) or, alternatively, AI alone in patients with hormone-receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) EBC.Methods Using an incidence-based approach, the model calculated total expected annual societal costs of disease-related events after cessation of adjuvant treatment with ribociclib plus AI or AI alone for HR+/HER2- EBC. The model includes five states: IDFS, non-metastatic recurrence (NMR), distant recurrence (DR), secondary primary malignancy (SPM) and death, with a one-year cycle length, and a new cohort entering each year. Health state transition probabilities are based on a previously published cost-effectiveness model (CEM). Costs are tallied only after IDFS (after cessation of adjuvant treatment) and include direct costs of medical care as well as indirect costs related to employment, productivity, and wage loss.Results At the 4-year NATALEE data cut-off (April 2024), ribociclib plus AI reduced the risk of an IDFS event by 28.5% versus AI alone (HR 0.715), corresponding in the model to 23% fewer non-fatal events (NMR, DR, and SPM), 18% lower mortality, 23% lower total direct costs (-$957,471,465), and 24% lower indirect costs (-$448,542,692) from the period of cessation of adjuvant therapy until death. Healthcare savings were driven primarily by fewer distant recurrences and deaths, while societal savings were largely due to reduced caregiver costs.Conclusions Treatments that reduce disease recurrence and mortality can significantly lower societal costs and alleviate burden on the healthcare system.
SN - 1198-0052
SN - 1718-7729
ER -