Budget impact analysis of capivasertib as a second-line therapy for advanced breast cancer in the United States

BACKGROUND: Capivasertib was the first AKT inhibitor approved by the US FDA as a second-line treatment for PIK3CA/AKT1/PTEN-altered, HR+/HER2- advanced breast cancer. However, capivasertib is costly. This study provides the first evidence on the financial impact for third-party payers to reimburse capivasertib. RESEARCH DESIGN AND METHODS: We estimated the change in total costs from adding capivasertib to the treatment mix over 3 years. The size of the target population was estimated using data on incidence and prevalence for breast cancer, PIK3CA/AKT1/PTEN alterations, and risk of failure to first-line treatment. Costs associated with drug administration, disease management, and adverse events were captured. Costs were measured in 2023 US dollars. RESULTS: In a 1-million-member population, 113, 114, and 115 individuals would be eligible for capivasertib treatment in years 1, 2, and 3, respectively. Adding capivasertib to the second-line setting would add $31,939,838 in net costs over 3 years. Specifically, drug costs would increase by $34,251,781 but would be offset by savings of $323,632 in adverse event costs and of $1,988,311 in follow-up costs. These net costs amount to $0.88 per-member-per-month. CONCLUSION: While introduction of capivasertib could reduce adverse event and follow-up costs, it may result in an overall increase in payers' budget.