Vol. 2 No. 2 (2022)
Reimbursement Recommendations

Alpelisib (Piqray)

Published February 11, 2022

Key Messages

  • CADTH recommends that Piqray should not be reimbursed by public drug plans in combination with fulvestrant for the treatment of postmenopausal women, and men, with hormone receptor–positive, human epidermal growth factor 2 (HER2)-negative, PIK3CA-mutated advanced or metastatic breast cancer after disease progression following an endocrine-based regimen with a cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitor.
  • There is not enough robust clinical evidence to demonstrate a benefit in adding Piqray to fulvestrant therapy in the relevant patient population.
  • It is unclear whether Piqray meets the needs identified by patients, including delaying disease progression, extending overall survival, and maintaining or improving quality of life. Patients also identified a need for a treatment with minimal side effects, but many patients in the studies discontinued treatment with Piqray due to side effects.