ArticleInternational journal of women's health2026
Cost-Effectiveness of Culmerciclib Plus Fulvestrant for Previously Treated HR-Positive/HER2-Negative Advanced Breast Cancer in China: An Integrated GBD 2023 Analysis.
Article in International journal of women's health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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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