Cost-Utility Analysis of Trastuzumab Deruxtecan Versus Treatment of Physician’s Choice in HER2-Positive Metastatic Breast Cancer in Chinese Setting
Author(s)
Hu S, Fan G
Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 31, China
Presentation Documents
OBJECTIVES: Trastuzumab deruxtecan (T-DXd) expressed a favorable benefit–risk profile for progression-free survival and overall survival compared with treatment of physician’s choice (TPC) in patients with HER2-positive metastatic breast cancer (mBC), becoming the second-line standard of care, promisingly. TPC was either capecitabine plus trastuzumab or capecitabine plus lapatinib. We aim to estimate the cost-effectiveness of T-DXd versus TPC in HER2-Positive mBC from the Chinese healthcare perspective.
METHODS: A partitioned survival model was used to evaluate the cost-effectiveness of T-DXd in comparison to TPC. Clinical patients and outcome data were obtained from the Destiny-Breast 02 trial, while costs and utilities were sourced within a Chinese setting. Total costs, quality-adjusted life months (QALMs), incremental cost-utility ratios (ICUR) were calculated for cost-utility analysis. The willingness-to-pay threshold was set at $3188/QALM. Univariate, scenario, and probabilistic sensitivity analyses were performed.
RESULTS: T-DXd group gained ∆QALM of 6.03 months and ∆Cost of $109,711.61 compared with TPC therapy, which caused an ICUR of $18,201.06 /QALM. The sensitivity analyses indicated consistent results. Additionally, T-DXd must reduce the price in the Chinese mainland market. At best, when the cycle cost of T-DXd of $2501.86, T-DXd has an 54.41% probability of being a better choice.
CONCLUSIONS: T-DXd appears not cost-effective compared with TPC for HER2-positive mBC patients who were refractory or resistant to trastuzumab emtansine in China.
Conference/Value in Health Info
Value in Health, Volume 27, Issue 12, S2 (December 2024)
Code
EE493
Topic
Economic Evaluation
Topic Subcategory
Cost-comparison, Effectiveness, Utility, Benefit Analysis
Disease
Drugs, Oncology
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