Table 3.

Economic parameters considered

Drug costs
Pharmaceutical form	EFP per package (€; 2017)a		Posologyc							Monthly cost (€; 2017)b
Ribociclib 200 mg, 63 tablets	4,444.44		Recommended starting dose: 600 mg/day for 21 days+7 days without treatment (3/1 scheme)							4,831.34
Ribociclib 200 mg, 42 tablets	2,962.96		After first dose reduction: 400 mg/day for 21 days+7 days without treatment (3/1 scheme)							3,220.90
Ribociclib 200 mg, 21 tablets	1,481.48		After second dose reduction: 200 mg/day for 21 days+7 days without treatment (3/1 scheme)							1,610.45
Palbociclib 125 mg, 21 capsules	3,600.00		Recommended starting dose: 125 mg/day for 21 days+7 days without treatment (3/1 scheme)							3,913.39
Palbociclib 100 mg, 21 capsules	3,600.00		After first dose reduction: 100 mg/day for 21 days+7 days without treatment (3/1 scheme)							3,913.39
Palbociclib 75 mg, 21 capsules	3,600.00		After second dose reduction: 75 mg/day for 21 days+7 days without treatment (3/1 scheme)							3,913.39
Letrozole GE 2.5 mg, 30 tablets	59.00		2.5 mg/day							59.86
Administration costs
Type of administration	Unit cost (€; 2017)d		Frequencyc
Parenteral administration	211.67		Per day of active treatment with parenteral chemotherapy, endocrine therapy, or targeted therapy
Costs attributed to health state
Resource use	Unit cost (€; 2017)d		Patients (%)		Frequency (PF state)				Frequency (PD state)
General medicine visits	22.59		50.00		1 visit/2 months				1 visit/2 months
Outpatient visits (oncology)	84.32		100.00		1 visit/month				1 visit/month
Nursing visits	26.73		25.00		1 visit/2 months				1 visit/month
Computed tomography	175.51		20.00		1 visit/3 months				1 visit/3.5 months
Bone scintigraphy	173.73		8.00		1 visit/6 months				1 visit/6.5 months
Hospitalizations	544.77		12.50		–				8 days
Monitoring costs
Resource use	Unit cost (€; 2017)d		Frequencyc Ribociclib+letrozole				Frequencyc Palbociclib+letrozole
Liver function tests	22.67		Baseline Every 2 weeks, cycles 1 and 2 Once, cycles 3, 4, 5, and 6				–
Complete blood count	4.16		Baseline Every 2 weeks, cycles 1 and 2 Once, cycles 3, 4, 5, and 6				Baseline Every 2 weeks, cycles 1 and 2 Once, remaining cycles. For patients without grade >2 neutropenia during first six cycles, monitoring every 3 months
Electrocardiogram	38.83		Baseline Every 2 weeks, cycle 1 Once, cycle 2				–
Adverse event costs
Adverse event	Diarrhea	Infection		Nausea		Febrile neutropenia		Pulmonary embolism		Vomiting
Unit cost (€; 2017)	738.10e	4,791.79f		589.65e		2,624.35e		4,543.68d		589.65e
End-of-life care
	Unit cost (€; 2017)		Patients (%)		Frequency
Palliative care unit	332.30f		40.00		2–3 weeks until death (mean, 15.19 days)
Home care, doctor’s visits	65.38d		12.50		2–3 visits/week until death (mean, 8.74 visits)
Home care, nurse visits	45.26d		12.50		2–3 visits/week until death (mean, 8.74 visits)
Acute hospital unit	540.81g		35.00		1–2 weeks until death (mean, 9.01 days)

Notes:

^aReported EFP from the Spanish drug prices database.¹⁶

^bEstimated from the described posology. A mean body surface area of 1.7 m² was considered.

^cTechnical specifications of the respective pharmaceutical forms.¹⁵

^dUsing average rates from the Spanish health costs database.³⁷

^eUnit cost updated to 2017 Euros from the study by Alba et al.¹³

^fUnit cost updated to 2017 Euros from the study by Isla et al.³⁶

^gUnit cost updated to 2017 Euros and estimated from NHS minimum basic data set.³⁸

Abbreviations: EFP, ex-factory price; GE, generic equivalent; NHS, national health system; PD, progressed disease; PF, progression-free.