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. 2025 Mar 19;23(1):8.
doi: 10.1186/s12962-025-00613-z.

Cost-effectiveness of sacituzumab govitecan for hormone receptor-positive human epidermal growth factor receptor 2-negative metastatic breast cancer based on the EVER-132-002 trial in China

Shixian Liu  1   2   3 , Kaixuan Wang  4 , Hao Chen  1   2   3 , Ziming Wan  1   2   3 , Lei Dou  1   2   3 , Shunping Li  5   6   7
Affiliations

Cost-effectiveness of sacituzumab govitecan for hormone receptor-positive human epidermal growth factor receptor 2-negative metastatic breast cancer based on the EVER-132-002 trial in China

Shixian Liu et al. Cost Eff Resour Alloc. .

Abstract

Background: The EVER-132-002 trial demonstrated the significant efficacy and manageable safety of sacituzumab govitecan in hormone receptor-positive human epidermal growth factor receptor 2-negative (HR + HER2-) metastatic breast cancer. This study evaluated the cost-effectiveness of sacituzumab govitecan compared with chemotherapy from the Chinese healthcare system perspective.

Methods: A partitioned survival model at 21-day intervals over a 10-year time horizon was developed to evaluate the total cost, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) at willingness-to-pay (WTP) threshold of 3 times gross domestic product per capita ($38,042.49 per QALY). Clinical data were extracted from the EVER-132-002 trial; direct medical costs and utility values were obtained from public bid-winning databases, local charges or published literature. To determine the model's robustness, scenario, one-way, two-way and probabilistic sensitivity analyses were performed.

Results: Compared with chemotherapy, sacituzumab govitecan generated an additional cost of $91,273.72, with an additional QALY of 0.43, resulted in an ICER of $211,948.62 per QALY. Patient weight was the most influential parameter on base-case results, and variations in each parameter did not substantially alter the conclusion. Probabilistic sensitivity analysis demonstrated that the probability of sacituzumab govitecan to be cost-effective was zero at the WTP threshold of $38,042.49 per QALY. Scenario analysis indicated that sacituzumab govitecan would be cost-effective versus chemotherapy only if its cost was reduced by 83% ($202.65 per unit) or more.

Conclusions: Sacituzumab govitecan might not be cost-effective compared with chemotherapy in the treatment for HR + HER2- metastatic breast cancer in China.

Keywords: Cost-effectiveness; Hormone receptor-positive; Human epidermal growth factor receptor 2-negative; Metastatic breast cancer; Sacituzumab Govitecan.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The structure of the partitioned survival model
Fig. 2
Fig. 2
The one-way sensitivity analyses of sacituzumab govitecan compared to chemotherapy in China. (Note: PD, progressive disease; PFS, progression-free survival; ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life-year)
Fig. 3
Fig. 3
The incremental cost-effectiveness scatter plot of sacituzumab govitecan compared to chemotherapy in China. (Note: PD, progressive disease; PFS, progression-free survival; ICER, incremental cost-effectiveness ratio; QALY, quality-adjusted life-year)
Fig. 4
Fig. 4
The cost-effectiveness acceptability curve of sacituzumab govitecan compared to chemotherapy in China. (Note: WTP, willingness to pay; QALY, quality-adjusted life-year)
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