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. 2021 Oct 28:11:734594.
doi: 10.3389/fonc.2021.734594. eCollection 2021.

Economic Evaluation of Sacituzumab Govitecan for the Treatment of Metastatic Triple-Negative Breast Cancer in China and the US

Jigang Chen  1   2 , Mingyang Han  3 , Aihua Liu  1   2 , Bo Shi  4
Affiliations

Economic Evaluation of Sacituzumab Govitecan for the Treatment of Metastatic Triple-Negative Breast Cancer in China and the US

Jigang Chen et al. Front Oncol. .

Abstract

Background: The effectiveness of Sacituzumab Govitecan (SG) for metastatic triple-negative breast cancer (mTNBC) has been demonstrated. We aimed to evaluate its cost-effectiveness on mTNBC from the Chinese and United States (US) perspective.

Methods: A partitioned survival model was developed to compare the cost and effectiveness of SG versus single-agent chemotherapy based on clinical data from the ASCENT phase 3 randomized trial. Cost and utility data were obtained from the literature. The incremental cost-effectiveness ratio (ICER) was measured, and one-way and probabilistic sensitivity analyses (PSA) were performed to observe model stability. A Markov model was constructed to validate the results.

Results: In China, SG yielded an additional 0.35 quality-adjusted life-year (QALY) at an additional cost of Chinese Renminbi ¥2257842. The ICER was ¥6375856 ($924037)/QALY. In the US, SG yielded the same additional QALY at an extra cost of $175393 and the ICER was $494479/QALY. Similar results were obtained from the Markov model. One-way sensitivity analyses showed that SG price had the greatest impact on the ICER. PSA showed the probability of SG to be cost-effective when compared with chemotherapy was zero at the current willing-to-pay threshold of ¥217341/QALY and $150000/QALY in China and the US, respectively. The probability of cost-effectiveness of SG would approximate 50% if its price was reduced to ¥10.44/mg in China and $3.65/mg in the US.

Conclusion: SG is unlikely to be a cost-effective treatment of mTNBC at the current price both in China and the US.

Keywords: China; Sacituzumab Govitecan; US; breast cancer; economic evaluation.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The comparison between the reconstructed Kaplan-Meier curves from the ASCENT trial and the best parametric fitting curves. CI: confidence interval.
Figure 2
Figure 2
Tornado diagram of one-way sensitivity analyses of Sacituzumab Govitecan versus single-agent chemotherapy in the treatment of metastatic triple-negative breast cancer from the Chinese perspective. ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life-years; SG, Sacituzumab Govitecan.
Figure 3
Figure 3
Tornado diagram of one-way sensitivity analyses of Sacituzumab Govitecan versus single-agent chemotherapy in the treatment of metastatic triple-negative breast cancer from the United States perspective. ICER: incremental cost-effectiveness ratio; QALY: quality-adjusted life-year; SG: Sacituzumab Govitecan.
Figure 4
Figure 4
Cost-effectiveness acceptability curves of Sacituzumab Govitecan versus single-agent chemotherapy in the treatment of metastatic triple-negative breast cancer from the United States payer perspective. QALY, quality-adjusted life-year; WTP, willingness-to-pay.
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