Capivasertib Cost-Effectiveness in Advanced Breast Cancer

Capivasertib, a novel AKT inhibitor, has gained approval as a second-line therapy for advanced breast cancer, but its high cost has sparked concerns about its economic viability. This review summarizes the results of the first published economic evaluation of Capivasertib in a cost-effectiveness study among patients with PIK3CA/AKT1/PTEN-altered, hormone receptor-positive (HR+), HER2-negative advanced breast cancer.

Key Insights:

• The study used a Markov model to compare three treatments. These included capivasertib plus fulvestrant for all patients, for postmenopausal women only, and fulvestrant alone.
• The incremental cost-effectiveness ratio for capivasertib plus fulvestrant was $280,854 per QALY. This exceeds the $100,000/QALY threshold.
• To be cost-effective, capivasertib’s price would need a 70% reduction, lowering it to $7,000 per cycle.

Evaluating Capivasertib´s Economic Value

The study evaluates capivasertib combined with fulvestrant for advanced breast cancer. It compares three approaches: capivasertib with fulvestrant for all patients, only for postmenopausal women, or fulvestrant alone. The model uses a U.S. payer perspective with 2023 dollars. It measures benefits in life years and quality of life over a patient’s lifetime. Multiple scenarios confirm the findings’ reliability. Adding capivasertib for all patients increases costs by $410,765 and extends quality life by 1.46 years. This yields a cost of $280,854 per quality life year gained. Restricting capivasertib to postmenopausal women proved less effective and remained overly expensive. These conclusions were consistent across multiple tested scenarios.

Pricing and Access Implications

Capivasertib’s high price creates access barriers for advanced breast cancer treatment. Its cost-effectiveness ratio of $280,854 per quality-adjusted life year exceeds the $100,000 threshold. This makes it unaffordable for many payers. A 70% price cut to $7,000 per cycle could align costs with benefits. This would improve access for patients with PIK3CA/AKT1/PTEN-altered, HR+/HER2− breast cancer. High costs may reduce use, especially in resource-limited settings. This could widen treatment disparities. Payers and manufacturers should consider value-based pricing or patient assistance programs to enhance affordability while leveraging the drug’s benefits.

In summary, capivasertib offers clinical value but costs too much. Pricing changes are essential to broaden access to this therapy.

For more details, refer to the study in SpringerLink.