Expert review of pharmacoeconomics & outcomes research · 2026
Cost-effectiveness analysis of sacituzumab tirumotecan as second-line therapy for EGFR-TKI-resistant, EGFR-mutated advanced NSCLC in China.
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He Jing, Yu Jialin, Liu Ruixuan, Yang Qing
Аннотация
BACKGROUND: This study estimated the cost-effectiveness of sacituzumab tirumotecan (Sac-TMT) versus pemetrexed-platinum chemotherapy as second-line therapy for advanced EGFR-mutated non-small cell lung cancer (NSCLC) in China.
RESEARCH DESIGN AND METHODS: A partitioned survival model based on the OptiTROP-Lung04 trial was developed from the Chinese healthcare perspective. The incremental cost-effectiveness ratio (ICER) was compared with a willingness-to-pay (WTP) threshold of $26,889.37/QALY. One-way, two-way, and probabilistic sensitivity analyses, together with scenario analyses, tested the robustness of the findings.
RESULTS: The base-case analysis results showed that over 10 years, Sac-TMT gained 0.86 additional QALYs at an incremental cost of $64,255.79, yielding an ICER of $75,704.42/QALY, exceeding the WTP threshold. Key drivers were patient body weight, the per-unit cost of Sac-TMT (180 mg), and the health utility value for the progressive disease state. The probability of Sac-TMT being cost-effective at the WTP threshold of $26,889.37/QALY was 0%. Patient assistance program reduced the ICER to $46,354.36/QALY. A price reduction exceeding 73.81% would bring the ICER below the WTP threshold.
CONCLUSION: At current prices, Sac-TMT is not cost-effective as second-line therapy for advanced EGFR-mutated NSCLC in China.
RESEARCH DESIGN AND METHODS: A partitioned survival model based on the OptiTROP-Lung04 trial was developed from the Chinese healthcare perspective. The incremental cost-effectiveness ratio (ICER) was compared with a willingness-to-pay (WTP) threshold of $26,889.37/QALY. One-way, two-way, and probabilistic sensitivity analyses, together with scenario analyses, tested the robustness of the findings.
RESULTS: The base-case analysis results showed that over 10 years, Sac-TMT gained 0.86 additional QALYs at an incremental cost of $64,255.79, yielding an ICER of $75,704.42/QALY, exceeding the WTP threshold. Key drivers were patient body weight, the per-unit cost of Sac-TMT (180 mg), and the health utility value for the progressive disease state. The probability of Sac-TMT being cost-effective at the WTP threshold of $26,889.37/QALY was 0%. Patient assistance program reduced the ICER to $46,354.36/QALY. A price reduction exceeding 73.81% would bring the ICER below the WTP threshold.
CONCLUSION: At current prices, Sac-TMT is not cost-effective as second-line therapy for advanced EGFR-mutated NSCLC in China.