ArticleBreast (Edinburgh, Scotland)2026
Cost-effectiveness of inavolisib-based therapy in PIK3CA-mutated advanced breast cancer in the USA.
Article in Breast (Edinburgh, Scotland), 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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6 authors.
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Abstract
purposeInavolisib plus palbociclib and fulvestrant has been approved for treating PIK3CA-mutated, hormone receptor-positive human epidermal growth factor receptor 2-negative (HR + HER2-), advanced breast cancer in the USA. This study evaluated the cost-effectiveness of inavolisib plus palbociclib and fulvestrant compared with palbociclib plus fulvestrant from the US payer perspective.
methodsWe developed a partitioned survival model at a 28-day cycle length over 15-year time horizons to predict total costs, life-years, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER), and incremental cost-utility ratio (ICUR) at willingness-to-pay (WTP) threshold of $150,000 per QALY. Survival data were extracted from the INAVO120 clinical trial, costs and utilities were obtained from the department of Veterans Affairs, published literature and quality-of-life studies using the EQ-5D-5L scale. Uncertainty was addressed via scenario, one-way and probabilistic sensitivity analyses.
resultsIn the base-case, inavolisib plus palbociclib and fulvestrant resulted in 1.99 life-years and 1.43 QALYs at an incremental cost of $211,639.64 with an ICER of $106,595.61 per life-year and an ICUR of $148,417.37 per QALY. The utility value of progression-free survival was the most influential parameter on the base-case results. Alterations in each model parameter did not significantly impact on the conclusions. The probability of inavolisib plus palbociclib and fulvestrant was cost-effective at the WTP threshold of $150,000 was 54.59%.
conclusionInavolisib plus palbociclib and fulvestrant may be a high-value treatment option for patients with PIK3CA-mutated, HR + HER2-, advanced breast cancer in the USA.
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