by Yitian Lang,
Qingqing Chai, Wenqi Tao, Yahui Liao, Xiaoyan Liu, Bin Wu
The Breast: Published: February 09, 2023
Purpose
The ASCENT trial
demonstrated the efficacy of sacituzumab govitecan for the treatment of advanced
or metastatic triple-negative breast cancer (TNBC). The current study evaluated
the cost-effectiveness of receiving sacituzumab govitecan compared with
standard of care chemotherapy from the United States payer perspective.
Methods
A partitioned
survival approach was used to project the disease course of advanced or
metastatic TNBC. Two survival modes were applied to analyze two groups of
patients. The survival data were gathered from the ASCENT trial. Direct medical
costs were derived from the data of Centers for Medicare & Medicaid
Services. Utility data was collected from the published literature. The
incremental cost-utility ratio (ICUR) was the primary outcome that measured the
cost-effectiveness of therapy regimen. One-way sensitivity and probabilistic
sensitivity analysis were implemented to explore the uncertainty and validate
the stability of results.
Results
In the base-case,
the ICUR of sacituzumab govitecan versus chemotherapy is $ 778,771.9/QALY and $
702,281/QALY for full population group and brain metastatic-negative (BMN)
group with the setting of classic survival mode. And in the setting of cure
survival mode, the ICUR is $ 506,504.5/QALY for the full population group and $
274,232.0/QALY for BMN population group. One-way sensitivity analyses revealed
that the unit cost of sacituzumab govitecan and body weight were key roles that
lower the ICUR value. Probabilistic sensitivity analyses also showed that
reducing the unit price of sacituzumab govitecan can improve the likelihood of
becoming cost-effective.
Conclusion
The
cost-effectiveness analysis suggested that from a US payer perspective,
sacituzumab govitecan at current price is unlikely to be a preferred option for
patients with advanced or metastatic TNBC at a threshold of $ 150,000/QALY.
