Vol. 6 No. 3 (2026)
Reimbursement Recommendations

Ribociclib (Kisqali)

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Published March 24, 2026

Key Messages

  • Canada’s Drug Agency (CDA-AMC) recommends that Kisqali in combination with an aromatase inhibitor (AI) should be reimbursed by public drug plans for the adjuvant treatment of adult patients with hormone receptor (HR)–positive, HER2‑negative stage II or III early breast cancer (eBC) at high risk for recurrence, if certain conditions are met.
  • Kisqali, in combination with an AI, should only be covered to treat adults with breast cancer that has receptors for estrogen and progesterone hormones, tests negative for the HER2 protein, has been surgically removed, and has not spread to other parts of the body. It should only be used in patients with stage IIA, IIB, or III disease. For stage IIA node-negative disease, the cancer must also be either grade 3 or grade 2 with high-risk features (e.g., a Ki-67 proliferation index score ≥ 20%), or the patient must have a high-risk result with a genomic test. Eligible patients should also have good performance status.
  • Kisqali, in combination with an AI, should only be reimbursed if prescribed by clinicians with expertise in managing eBC and if the cost of Kisqali is reduced.