WU Yanan,WU Fang,HOU Yanhong.Cost-utility analysis of trastuzumab deruxtecan versus trastuzumab emtansine in the second-line treatment for HER2-positive metastatic breast cancer[J].ZHONGGUO YAOFANG,2024,35(02):204-209.
WU Yanan,WU Fang,HOU Yanhong.Cost-utility analysis of trastuzumab deruxtecan versus trastuzumab emtansine in the second-line treatment for HER2-positive metastatic breast cancer[J].ZHONGGUO YAOFANG,2024,35(02):204-209. DOI: 10.6039/j.issn.1001-0408.2024.02.14.
Cost-utility analysis of trastuzumab deruxtecan versus trastuzumab emtansine in the second-line treatment for HER2-positive metastatic breast cancer
To evaluate the cost-effectiveness of trastuzumab deruxtecan(T-DXd) versus trastuzumab emtansine (T-DM1) in the second-line treatment of
HER2
-positive metastatic breast cancer, and to provide a basis for the selection of clinical medication regimen and medical and health decisions.
METHODS
2
Based on the clinical trial DESTINY-Breast03, a partitioned survival model was constructed, with a cycle of 3 weeks as the simulation of patients’ lifetime. The incremental cost-effectiveness ratio (ICER) was calculated by using quality-adjusted life years (QALY) as output indicators, and sensitivity analysis was used to verify the robustness of the basic analysis results; the cost-effectiveness of the second-line treatment for
HER2
-positive metastatic breast cancer was compared between T-DXd and T-DM1.
RESULTS
2
Under the premise of taking 3 times China’s per capita gross domestic product (GDP) in 2022 as the willingness-to-pay threshold (257 094 yuan/QALY), the T-DXd group also needed to pay more cost compared with T-DM1 group while obtaining incremental utility (0.69 QALYs), and the ICER value was 1 850 478.40 yuan/QALY. The results of univariate sensitivity analysis showed that progression-free survival state utility value, T-DXd price, cost discount rate were factors that had a great influence on ICER value, but these parameters could not flip the basic analysis results within a reasonable range. In the probability sensitivity analysis, when the threshold of willingness-to-pay rose to 1 500 400 yuan/QALY, the probability of economic activity was 50% in the T-DXd regimen. The results of the scenario analysis also verified the robustness of the original research results.
CONCLUSIONS
2
Under the premise of 3 times China’s per capita GDP as the WTP threshold, compared with T-DM1, T-DXd is not cost-effective in the second-line treatment of
HER2
-positive metastatic breast cancer.
关键词
德曲妥珠单抗恩美曲妥珠单抗HER2阳性转移性乳腺癌分区生存模型成本-效用分析
Keywords
trastuzumab emtansineHER2-positive metastatic breast cancerpartitioned survival modelcost-utility analysis
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