Presentation (CTI)

OBJECTIVES: Patients with EGFR-mutant advanced non-small cell lung cancer (NSCLC) inevitably progress on EGFR tyrosine kinase inhibitor (TKI) therapy, creating demand for effective subsequent-line options. This study evaluated the cost-effectiveness of Sac-TMT, a novel TROP2-directed antibody-drug conjugate (ADC), compared to docetaxel from the Chinese healthcare system perspective, providing evidence for national reimbursement decisions and informing global health technology assessment discussions on addressing post-TKI resistance.
METHODS: A partitioned survival model with a lifetime horizon was developed. Survival data was sourced from the individual patient data of the Phase III OptiTROP-Lung03 Part II trial. Utilities and costs (using the latest 2025 National Reimbursement Drug List prices) were derived from published literature and databases. Outcomes were measured in quality-adjusted life years (QALYs) and costs. The incremental cost-effectiveness ratio (ICER) was calculated, with sensitivity analyses (deterministic, probabilistic) and scenario analyses performed to test robustness. The analysis adhered to the CHEERS 2022 guidelines and ISPOR-SMDM modeling good practices.
RESULTS: In the base case, Sac-TMT yielded an incremental cost of ¥69,912.53 and an incremental utility of 0.85 QALYs, resulting in an ICER of ¥81,837.38 per QALY gained​ (approximately 0.85 times China's 2024 per capita GDP). Probabilistic sensitivity analysis showed a greater than 95% probability​ of Sac-TMT being cost-effective at a willingness-to-pay threshold of 1×GDP threshold. Scenario analyses confirmed the base-case conclusion.
CONCLUSIONS: For patients with EGFR-mutant advanced NSCLC after failure of EGFR-TKI and platinum-based chemotherapy, Sac-TMT is a cost-effective​ treatment strategy compared to docetaxel within the Chinese healthcare system. At its current national reimbursement price, Sac-TMT is a highly cost-effective treatment option compared to other therapies for EGFR-mutated NSCLC patients in China. The findings supported its inclusion in NRDL access and further demonstrated its economic value.