Trastuzumab deruxtecan versus chemotherapy treated in patients with HER2-positive metastatic breast cancer: a cost-effectiveness analysis based on the DESTINY-Breast02 trial

ABSTRACT

Objectives

This study aims to conduct a cost-effectiveness analysis of trastuzumab deruxtecan versus chemotherapy for HER2-positive metastatic breast cancer from the perspective of the Chinese healthcare system.

Methods

A three-state partitioned survival model was constructed to simulate the treatment. The analysis yielded information on the costs, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). Sensitivity analyses have been carried out to scrutinize the model’s uncertainties

Results

The total cost for the trastuzumab deruxtecan group was found to be $228601.57, while the chemotherapy group incurred a total cost of $84901.38. It was found that the trastuzumab deruxtecan group exhibited an incremental gain of 2.95 QALYs in comparison to the chemotherapy group. However, this additional benefit came at an additional cost of $143700.19 for the trastuzumab deruxtecan treatment, calculated in the ICER at $48711.93/QALY, which surpasses the willingness-to-pay threshold of $37304.34/QALY in China. Sensitivity analyses indicated that the results were robust to variations in key parameters and assumptions.

Conclusion

Trastuzumab deruxtecan was not a cost-effective treatment option for patients with HER2-positive metastatic breast cancer in China. However, the use of trastuzumab deruxtecan may offer a cost-effective treatment alternative provided that its price is diminished.

KEYWORDS:

• Trastuzumab deruxtecan
• cost-effectiveness
• HER2-positive
• metastatic breast cancer
• chemotherapy

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Authors’ contributions

ZZ made substantial contributions to the conception and design of the research. HC and SX played a crucial role in collecting the data and conducted rigorous statistical analysis. ZZ was responsible for drafting the initial version of the article. HC reviewed the manuscript and provided final approval. All authors carefully reviewed and approved the final version of the manuscript.

Availability of data and material

The data used in the current investigation are available with reasonable request from the corresponding author.

Ethics approval and consent to participate

Our study is based on computer modeling techniques and does not contain any new studies with human participants, it does not require the approval of the ethics committee.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14737167.2023.2291157.

Additional information

Funding

This paper was not funded.