Presentation (CTI)

OBJECTIVES: To evaluate the cost-effectiveness of Sacituzumab Tirumotecan (Sac-TMT), a TROP2-directed antibody-drug conjugate (ADC), versus treatment of physician’s choice (TPC) for patients with unresectable locally advanced or metastatic triple-negative breast cancer (mTNBC) who have received ≥2 prior systemic therapies from the Chinese healthcare system perspective, providing evidence for national reimbursement decisions.
METHODS: A lifetime partitioned survival model with weekly cycles was developed. Clinical efficacy (progression-free, overall survival and time to discontinuation) was sourced from the individual patient data of the phase III OptiTROP-Breast01 trial. Health state utilities were derived by mapping EORTC QLQ-C30 data to EQ-5D-3L values. Costs (2025 Chinese Yuan, ¥) included drug acquisition (using the latest National Reimbursement Drug List prices), administration, adverse event management, and subsequent anti-cancer therapies. Outcomes were measured in quality-adjusted life years (QALYs) and costs. The incremental cost-effectiveness ratio (ICER) was calculated. Deterministic (DSA) and probabilistic (PSA) sensitivity analyses were conducted. The analysis adhered to the CHEERS 2022 guidelines and ISPOR-SMDM modeling good practices.
RESULTS: Treatment with Sac-TMT yielded an incremental 0.34 QALYs at an increased cost of ¥12,632, resulting in an ICER of ¥36,888/QALY. This represents 0.39 times the 2024 per capita GDP. The PSA demonstrated a 100% probability of Sac-TMT being cost-effective at the 1×GDP WTP threshold. The DSA indicated that the model results were most sensitive to variations in drug costs, but the ICER remained below the 1×GDP threshold across all plausible ranges.
CONCLUSIONS: Sac-TMT offers superior health benefits and demonstrates robust economic value compared with TPC. At its current national reimbursement price, Sac-TMT is a highly cost-effective treatment option compared to TPC for patients with pre-treated mTNBC in China. This analysis provides robust economic evidence to support its value and informed resource allocation decisions following its inclusion in the national reimbursement drug list.