Presentation (CTI)

OBJECTIVES: This study aimed to provide a comprehensive review on cost-effectiveness of sacituzumab govitecan (SG) in patients with metastatic triple-negative breast cancer (mTNBC).
METHODS: A systematic literature search was performed in PubMed, Medline, Embase and DOAJ using relevant search strings till December 2025. A supplementary open search was run-on Google Scholar to identify any missed relevant articles. The studies were screened and relevant data were extracted by three reviewers independently. The quality of reporting and the risk of bias of the included economic evaluations were assessed qualitatively using CHEERS and ECOBIAS checklist, respectively.
RESULTS: Eight studies reporting economic evaluations of SG were included. The time-horizon was 10 years in all studies, except for one which used 5-year time horizon. Four studies were reported from healthcare system perspective, three studies from the payer perspective, and one from both healthcare system and payer perspective. All QALYs and costs were discounted at an annual rate of 5% for China and 3% for US, Spain and Taiwan in the studies. The median life-years gained was 0.33 (range: 0.23 to 0.41) years, whereas the median QALYs gained was 0.35 (0.20 to 4.47) years. The studies reported a median incremental cost of USD 204,299.90 (81,140.06 to 505,854.00) for SG vs chemotherapy. The median ICER for SG vs chemotherapy was USD 494,479.00 (113,277.00 to 1,252,295.00). The median INMB for SG vs chemotherapy across the studies was USD -170,171.25 (-274,723.44 to -73,073.25). The one-way sensitivity analyses in majority of studies reported that unit price of SG was the primary drivers of the model outcomes.All the included studies ranked "high" on the CHEERS 2022 checklist and were graded to have a "moderate" risk of bias as per the ECOBIAS checklist.
CONCLUSIONS: These findings suggest that SG is unlikely to be a cost-effective treatment of mTNBC, with drug cost being the major contributor.