Cost-effectiveness of sacituzumab govitecan in hormone receptor-positive/human epidermal growth factor receptor 2-negative metastatic breast cancer

Frontiers in Oncology

Oncology

Yan Li¹  Xueyan Liang¹  Lingyuan Chen²  Demin Shi³ 

[1] Department of Pharmacy, Guangxi Academy of Medical Sciences and the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi, China;Department of Pharmacy, The People’s Hospital of Hechi, Hechi, Guangxi, China;Department of Reproductive Medicine, The People’s Hospital of Hechi, Hechi, Guangxi, China;

关键词: cost-effectiveness;    sacituzumab govitecan;    breast cancer;    hormone receptor-positive;    human epidermal receptor 2-negative;    partitioned survival model;   

DOI  :  10.3389/fonc.2023.1162360

 received in 2023-02-09, accepted in 2023-05-02,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundThe efficiency and safety of sacituzumab govitecan (SG) for the therapy of hormone receptor-positive (HR+)/human epidermal receptor 2-negative (HER2-) metastatic breast cancer (BC) has been demonstrated. The aim of this study is to evaluate its cost-effectiveness on HR+/HER2- metastatic BC from the third-party payer perspective in the United States.MethodsWe performed the cost-effectiveness of SG and chemotherapy using a partitioned survival model. TROPiCS-02 provided clinical patients for this study. We evaluated the robustness of this study by one-way and probabilistic sensitivity analyses. Subgroup analyses were also conducted. The outcomes were costs, life-years, quality-adjusted life years (QALYs), incremental cost-effectiveness ratio (ICER), incremental net health benefit (INHB), and incremental net monetary benefit (INMB).ResultsSG treatment was related to an increase of 0.284 life years and 0.217 QALYs over chemotherapy, as well as a cost increase of $132,689, reaching an ICER of $612,772/QALY. The INHB was -0.668 QALYs, and the INMB was -$100,208. SG was not cost-effective at the willingness to pay (WTP) threshold of $150,000/QALY. The outcomes were sensitive to patient body weight and cost of SG. SG may be cost-effective at the WTP threshold of $150,000/QALY if the price is less than $3.997/mg or the weight of patients is under 19.88 kg. Based on the subgroup analysis, SG did not prove cost-effective in all subgroups at the WTP threshold of $150,000/QALY.ConclusionFrom a third-party payer standpoint in the United States, SG was not cost-effective, even though it had a clinically significant advantage over chemotherapy for the treatment of HR+/HER2- metastatic BC. The cost-effectiveness of SG can be improved if the price is substantially reduced.

【 授权许可】

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Copyright © 2023 Shi, Li, Liang and Chen