{"id":"https://openalex.org/W7225740423","doi":"https://doi.org/10.57264/cer-2026-0064","title":"Cost-effectiveness analysis of ribociclib plus an aromatase inhibitor versus abemaciclib plus endocrine therapy in the adjuvant treatment of HR+/HER2- early breast cancer: a Canadian payer perspective","display_name":"Cost-effectiveness analysis of ribociclib plus an aromatase inhibitor versus abemaciclib plus endocrine therapy in the adjuvant treatment of HR+/HER2- early breast cancer: a Canadian payer perspective","publication_year":2026,"publication_date":"2026-11-10","ids":{"openalex":"https://openalex.org/W7225740423","doi":"https://doi.org/10.57264/cer-2026-0064"},"language":"en","primary_location":{"id":"doi:10.57264/cer-2026-0064","doi":"https://doi.org/10.57264/cer-2026-0064","is_oa":true,"landing_page_url":"https://doi.org/10.57264/cer-2026-0064","pdf_url":null,"source":{"id":"https://openalex.org/S2489859990","display_name":"Journal of Comparative Effectiveness Research","issn_l":"2042-6305","issn":["2042-6305","2042-6313"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","medline","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310321119","host_organization_name":"Future Medicine","host_organization_lineage":["https://openalex.org/P4310321119"],"host_organization_lineage_names":["Future Medicine"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Comparative Effectiveness Research","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://doi.org/10.57264/cer-2026-0064","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5139459526","display_name":"Dina Soliman","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210161737","display_name":"Novartis (Canada)","ror":"https://ror.org/05afs3z13","country_code":"CA","type":"company","lineage":["https://openalex.org/I1283582996","https://openalex.org/I4210161737"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Dina Soliman","raw_affiliation_strings":["Novartis Pharmaceuticals Canada, Montreal, QC, H2Y 0C, Canada"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Novartis Pharmaceuticals Canada, Montreal, QC, H2Y 0C, Canada","institution_ids":["https://openalex.org/I4210161737"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5022801937","display_name":"Christine Brezden\u2010Masley","orcid":"https://orcid.org/0000-0002-4818-318X","observed_orcids":["https://orcid.org/0000-0002-4818-318X"]},"institutions":[{"id":"https://openalex.org/I1291836623","display_name":"Mount Sinai Hospital","ror":"https://ror.org/05deks119","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I1291836623","https://openalex.org/I4210130843"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Christine Brezden-Masley","raw_affiliation_strings":["Mount Sinai Hospital, Toronto, ON, M5G 1X5, Canada"],"raw_orcid":"https://orcid.org/0000-0002-4818-318X","affiliations":[{"raw_affiliation_string":"Mount Sinai Hospital, Toronto, ON, M5G 1X5, Canada","institution_ids":["https://openalex.org/I1291836623"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5077041865","display_name":"Sandeep R. Sehdev","orcid":"https://orcid.org/0000-0001-7434-2263","observed_orcids":["https://orcid.org/0000-0001-7434-2263"]},"institutions":[{"id":"https://openalex.org/I2800722420","display_name":"Ottawa Hospital","ror":"https://ror.org/03c62dg59","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I2800722420"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Sandeep Sehdev","raw_affiliation_strings":["The Ottawa Hospital Cancer Centre, Ottawa, ON, K1H 8L6, Canada"],"raw_orcid":"https://orcid.org/0000-0001-7434-2263","affiliations":[{"raw_affiliation_string":"The Ottawa Hospital Cancer Centre, Ottawa, ON, K1H 8L6, Canada","institution_ids":["https://openalex.org/I2800722420"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5106279712","display_name":"Natalia Sabater Anaya","orcid":"https://orcid.org/0009-0004-8638-9754","observed_orcids":["https://orcid.org/0009-0004-8638-9754"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Natalia Sabater-Anaya","raw_affiliation_strings":["Avalere Health, Boston, Washington, DC 20005, USA"],"raw_orcid":"https://orcid.org/0009-0004-8638-9754","affiliations":[{"raw_affiliation_string":"Avalere Health, Boston, Washington, DC 20005, USA","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5006613735","display_name":"Talitha Vincken","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Talitha Vincken","raw_affiliation_strings":["Avalere Health, Rotterdam, 3068 AV, The Netherlands"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Avalere Health, Rotterdam, 3068 AV, The Netherlands","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10804","display_name":"Health Systems, Economic Evaluations, Quality of Life","score":0.8163999915122986,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},"topics":[{"id":"https://openalex.org/T10804","display_name":"Health Systems, Economic Evaluations, Quality of Life","score":0.8163999915122986,"subfield":{"id":"https://openalex.org/subfields/2002","display_name":"Economics and Econometrics"},"field":{"id":"https://openalex.org/fields/20","display_name":"Economics, Econometrics and Finance"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}},{"id":"https://openalex.org/T12829","display_name":"Advanced Breast Cancer Therapies","score":0.16279999911785126,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10183","display_name":"Breast Cancer Treatment Studies","score":0.00419999985024333,"subfield":{"id":"https://openalex.org/subfields/1306","display_name":"Cancer Research"},"field":{"id":"https://openalex.org/fields/13","display_name":"Biochemistry, Genetics and Molecular Biology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9330999851226807},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.6728000044822693},{"id":"https://openalex.org/C143998085","wikidata":"https://www.wikidata.org/wiki/Q162555","display_name":"Oncology","level":1,"score":0.6287999749183655},{"id":"https://openalex.org/C530470458","wikidata":"https://www.wikidata.org/wiki/Q128581","display_name":"Breast cancer","level":3,"score":0.5494999885559082},{"id":"https://openalex.org/C2778504769","wikidata":"https://www.wikidata.org/wiki/Q3040305","display_name":"Aromatase inhibitor","level":5,"score":0.5055999755859375},{"id":"https://openalex.org/C72563966","wikidata":"https://www.wikidata.org/wiki/Q1303415","display_name":"Cohort","level":2,"score":0.4823000133037567},{"id":"https://openalex.org/C2777863537","wikidata":"https://www.wikidata.org/wiki/Q357896","display_name":"Adjuvant","level":2,"score":0.46389999985694885},{"id":"https://openalex.org/C2778812593","wikidata":"https://www.wikidata.org/wiki/Q194974","display_name":"Letrozole","level":5,"score":0.44769999384880066},{"id":"https://openalex.org/C2780482068","wikidata":"https://www.wikidata.org/wiki/Q5508491","display_name":"Fulvestrant","level":5,"score":0.42410001158714294},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.4020000100135803},{"id":"https://openalex.org/C2776215463","wikidata":"https://www.wikidata.org/wiki/Q419143","display_name":"Anastrozole","level":5,"score":0.4016000032424927},{"id":"https://openalex.org/C2778715236","wikidata":"https://www.wikidata.org/wiki/Q55622662","display_name":"Discontinuation","level":2,"score":0.3903999924659729},{"id":"https://openalex.org/C84606932","wikidata":"https://www.wikidata.org/wiki/Q416496","display_name":"Estrogen receptor","level":4,"score":0.37290000915527344},{"id":"https://openalex.org/C207103383","wikidata":"https://www.wikidata.org/wiki/Q3930246","display_name":"Hazard ratio","level":3,"score":0.36469998955726624},{"id":"https://openalex.org/C2775930923","wikidata":"https://www.wikidata.org/wiki/Q12859063","display_name":"Metastatic breast cancer","level":4,"score":0.33000001311302185},{"id":"https://openalex.org/C187960798","wikidata":"https://www.wikidata.org/wiki/Q7631152","display_name":"Subgroup analysis","level":3,"score":0.3276999890804291},{"id":"https://openalex.org/C29456083","wikidata":"https://www.wikidata.org/wiki/Q1221899","display_name":"Gynecology","level":1,"score":0.3086000084877014},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.3050999939441681},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.29809999465942383},{"id":"https://openalex.org/C197934379","wikidata":"https://www.wikidata.org/wiki/Q2047938","display_name":"Adverse effect","level":2,"score":0.2903999984264374},{"id":"https://openalex.org/C46699223","wikidata":"https://www.wikidata.org/wiki/Q11078","display_name":"Endocrine system","level":3,"score":0.2815999984741211},{"id":"https://openalex.org/C17923572","wikidata":"https://www.wikidata.org/wiki/Q7250160","display_name":"Propensity score matching","level":2,"score":0.27799999713897705},{"id":"https://openalex.org/C50382708","wikidata":"https://www.wikidata.org/wiki/Q223218","display_name":"Proportional hazards model","level":2,"score":0.26989999413490295},{"id":"https://openalex.org/C23589133","wikidata":"https://www.wikidata.org/wiki/Q412005","display_name":"Hormone receptor","level":4,"score":0.26649999618530273},{"id":"https://openalex.org/C203092338","wikidata":"https://www.wikidata.org/wiki/Q1340863","display_name":"Clinical endpoint","level":3,"score":0.2653000056743622},{"id":"https://openalex.org/C2779668873","wikidata":"https://www.wikidata.org/wiki/Q6693756","display_name":"Lower risk","level":3,"score":0.26420000195503235}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.57264/cer-2026-0064","doi":"https://doi.org/10.57264/cer-2026-0064","is_oa":true,"landing_page_url":"https://doi.org/10.57264/cer-2026-0064","pdf_url":null,"source":{"id":"https://openalex.org/S2489859990","display_name":"Journal of Comparative Effectiveness Research","issn_l":"2042-6305","issn":["2042-6305","2042-6313"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","medline","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310321119","host_organization_name":"Future Medicine","host_organization_lineage":["https://openalex.org/P4310321119"],"host_organization_lineage_names":["Future Medicine"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Comparative Effectiveness Research","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.57264/cer-2026-0064","doi":"https://doi.org/10.57264/cer-2026-0064","is_oa":true,"landing_page_url":"https://doi.org/10.57264/cer-2026-0064","pdf_url":null,"source":{"id":"https://openalex.org/S2489859990","display_name":"Journal of Comparative Effectiveness Research","issn_l":"2042-6305","issn":["2042-6305","2042-6313"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","dongbi-c","medline","poland-70","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310321119","host_organization_name":"Future Medicine","host_organization_lineage":["https://openalex.org/P4310321119"],"host_organization_lineage_names":["Future Medicine"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Comparative Effectiveness Research","raw_type":"journal-article"},"sustainable_development_goals":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":10,"referenced_works":["https://openalex.org/W2038715542","https://openalex.org/W2134291881","https://openalex.org/W2789771941","https://openalex.org/W3087501542","https://openalex.org/W4220778872","https://openalex.org/W4311018441","https://openalex.org/W4322774367","https://openalex.org/W4392977246","https://openalex.org/W4413807142","https://openalex.org/W4414508430"],"related_works":[],"abstract_inverted_index":{"Aim:":[0],"Ribociclib":[1,211,307],"and":[2,93,155,168,177,198,206,225,248,278,299,315],"abemaciclib,":[3],"cyclin-dependent":[4],"kinase":[5],"4/6":[6],"inhibitors,":[7],"are":[8],"adjuvant":[9],"treatments":[10],"for":[11,137,304],"hormone":[12],"receptor-positive":[13],"(HR+),":[14],"human":[15],"epidermal":[16],"growth":[17],"factor":[18],"receptor":[19],"2-negative":[20],"(HER2-)":[21],"early":[22],"breast":[23],"cancer":[24],"(EBC).":[25],"In":[26,235],"the":[27,50,98,141,145,156,173,236,262,289,295,300,329,333],"Phase":[28],"III":[29],"NATALEE":[30,130,166],"trial,":[31],"ribociclib":[32,53,176,242,256,296],"plus":[33,54,58,153,212,240,257,308,319],"an":[34],"aromatase":[35],"inhibitor":[36],"(AI)":[37],"significantly":[38],"improved":[39],"invasive":[40],"disease-free":[41],"survival":[42],"(IDFS)":[43],"versus":[44,56,238,259,312,317],"AI":[45,55,160,213,258,260,309,313],"alone.":[46,161],"This":[47],"study":[48],"assessed":[49],"cost-effectiveness":[51,208,265],"of":[52,129,144,218,228,276,283],"abemaciclib":[57,138,152,178,239,318],"endocrine":[59],"therapy":[60],"(ET)":[61],"from":[62,97,332],"a":[63,114,127,272,279],"Canadian":[64,99],"public":[65],"payer":[66],"perspective":[67,102],"in":[68,274,281,321],"high-risk":[69,330],"HR+/HER2-":[70,324],"EBC.":[71],"Materials":[72],"&":[73],"methods:":[74],"A":[75],"nonhomogeneous,":[76],"semi-Markov":[77],"cohort":[78],"model":[79],"with":[80,271,323],"six":[81],"health":[82],"states":[83],"(IDFS,":[84],"second":[85],"primary":[86,149],"malignancy,":[87],"nonmetastatic":[88],"recurrence,":[89],"remission,":[90],"distant":[91],"recurrence":[92],"death)":[94],"was":[95,151,163,169,193,243,267],"developed":[96],"healthcare":[100],"system":[101],"using":[103,165,195],"Ontario-based":[104],"costs.":[105],"The":[106,123,148,190],"base":[107,191],"case":[108,192],"included":[109,159,200],"direct":[110],"medical":[111],"costs":[112,217,275,298],"over":[113],"lifetime":[115,216],"horizon":[116],"(49":[117],"years;":[118],"starting":[119],"age":[120],"52.4":[121],"years).":[122],"analysis":[124],"focused":[125],"on":[126,140,180],"subgroup":[128],"patients":[131],"who":[132,326],"would":[133,327],"have":[134],"been":[135],"eligible":[136],"based":[139,179],"inclusion":[142],"criteria":[143,331],"monarchE":[146,334],"trial.":[147,335],"comparator":[150,158],"ET":[154,320],"secondary":[157],"IDFS":[162,301],"estimated":[164,263],"data":[167],"assumed":[170],"to":[171,223,233,294],"be":[172],"same":[174],"between":[175],"indirect":[181],"evidence.":[182],"Other":[183],"transitions":[184],"were":[185,291],"informed":[186],"by":[187,246,252],"published":[188],"sources.":[189],"evaluated":[194],"probabilistic":[196],"analyses,":[197],"outcomes":[199],"costs,":[201],"life-years,":[202],"quality-adjusted":[203],"life-years":[204],"(QALYs),":[205],"incremental":[207,264],"ratios.":[209],"Results:":[210],"yielded":[214],"total":[215,226],"$155,277":[219],"(95%":[220,230],"CI:":[221,231],"$100,721":[222],"$238,620)":[224],"QALYs":[227,251,282],"13.06":[229],"12.33":[232],"13.83).":[234],"comparison":[237],"ET,":[241],"less":[244],"costly":[245],"$16,672,":[247],"had":[249],"greater":[250],"0.01.":[253],"When":[254],"comparing":[255],"alone,":[261],"ratio":[266],"$43,025":[268],"per":[269],"QALY,":[270],"difference":[273,280],"$29,693":[277],"0.69.":[284],"Sensitivity":[285],"analyses":[286],"demonstrated":[287],"that":[288],"results":[290],"most":[292],"sensitive":[293],"medication":[297],"hazard":[302],"rate":[303],"AI.":[305],"Conclusion:":[306],"is":[310],"cost-effective":[311],"alone":[314],"cost-saving":[316],"persons":[322],"EBC":[325],"meet":[328]},"counts_by_year":[],"updated_date":"2026-11-11T12:16:26.678958","created_date":"2026-11-11T00:00:00"}