OBJECTIVE  To assess the cost-effectiveness of sacituzumab tirumotecan in the treatment of unresectable locally advanced or metastatic triple-negative breast cancer(TNBC) from the perspective of Chinese healthcare system.

METHODS  A three-state Markov model was constructed based on the interim analysis data of the OptiTROP-Breast01 clinical trial to evaluate the cost-utility of sacituzumab tirumotecan relative to chemotherapy. The cycle length was set at 3 weeks, with a study horizon of 10 years. Total costs and quality-adjusted life year(QALY) were calculated using a 5% discount rate. The incremental cost-effectiveness ratio(ICER) was employed for economic evaluation. Univariate sensitivity analysis and probabilistic sensitivity analysis were conducted on relevant model parameters to verify the robustness of the results.

RESULTS  Compared with the chemotherapy group, sacituzumab tirumotecan provided an incremental utility of 0.34QALY for patients with unresectable locally advanced or metastatic TNBC, while incurring an additional treatment cost of 308473 yuan. The ICER was determined to be 918179 yuan·QALY⁻¹. Univariate sensitivity analysis revealed that the per-cycle cost of sacituzumab tirumotecan had the most significant impact on the results. Probabilistic sensitivity analysis indicated that the probability of sacituzumab tirumotecan being cost-effective at the pre-defined willingness-to-pay threshold of 268074 yuan·QALY⁻¹ was 0. Scenario analysis demonstrated that the study conclusions remained robust across different study durations(5, 10 and 15 years).

CONCLUSION  From the perspective of Chinese healthcare system, at its current price of 9399 yuan per 200 mg, sacituzumab tirumotecan is not cost-effective compared with chemotherapy for the later-line treatment of unresectable locally advanced or metastatic TNBC.