Presentation (CTI)

OBJECTIVES: Trastuzumab rezetecan, a novel antibody-drug conjugate, was firstly approved in China in May 2025 for the treatment of adult patients with advanced HER2-mutant non-small-cell lung cancer (NSCLC) who have received at least one prior systemic therapy. This study aims to assess the cost-effectiveness of trastuzumab rezetecan versus trastuzumab deruxtecan in HER2-mutant NSCLC from the Chinese healthcare perspective.
METHODS: A cost-utility analysis was conducted using a three-state partitioned survival model to simulate costs and health outcomes. The model adopted a 21-day cycle and lifetime horizon. Given the absence of head-to-head comparison between the two drugs, an unanchored matching-adjusted indirect comparison (MAIC) was conducted using individual patient data from HORIZON-Lung and published aggregate data from DESTINY-LUNG05. Costs and utility values were obtained from published literature and clinical expert surveys. Scenario analysis was conducted to compare efficacy against data from DESTINY-LUNG02, an international trial of trastuzumab deruxtecan. One-way sensitivity analysis and probabilistic sensitivity analysis were performed to assess the robustness of the base case findings.
RESULTS: In the base case analysis, trastuzumab rezetecan saved Chinese Yuan 73,663 (333,584 vs 407,247) and gained an additional 0.59 (2.21 vs 1.61) quality-adjusted life years compared to trastuzumab deruxtecan, establishing it as a strongly dominant treatment option. In scenario analysis, trastuzumab rezetecan maintained strong dominance over trastuzumab deruxtecan when compared to its international clinical trials. Sensitivity analyses confirmed the robustness of the results.
CONCLUSIONS: Trastuzumab rezetecan exhibits greater cost-effectiveness than trastuzumab deruxtecan. Building on its efficacy advantages, trastuzumab rezetecan offers a novel therapeutic option for HER2-mutant NSCLC patients, thereby enhancing their overall health outcomes.