Economic Evaluation of Treatment With Trastuzumab Deruxtecan for HER2-Low Advanced or Metastatic Breast Cancer in Previously Treated Patients.

IF 2.1 Q2 ECONOMICS

PharmacoEconomics Open Pub Date : 2025-09-01 Epub Date: 2025-08-05 DOI:10.1007/s41669-025-00592-0

Silvia Fenix-Caballero, Pablo Caleffa-Menendez, Carmen Maria Dominguez-Santana, Emilio Jesus Alegre-Del-Rey, Antonio Olry de Labry Lima

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引用次数: 0

Abstract

Objectives: This study evaluates the efficiency and budgetary impact of trastuzumab deruxtecan (T-DXd) compared with standard therapy in previously treated HER2-low advanced or metastatic breast cancer, from the perspective of the Spanish National Health System.

Methods: A partitioned survival model was developed using data from the DESTINY-BREAST04 trial. Health outcomes were measured in quality-adjusted life years (QALYs) for both the overall population and the hormone receptor-positive (RH+) subgroup. The analysis was conducted from the perspective of the Spanish National Health System over a 75-month time horizon. A univariate sensitivity analysis was performed to explore parameter uncertainty. Costs were derived from Spanish healthcare databases and expert input.

Results: At 75 months, for the overall patient population, the total healthcare cost for patients treated with T-DXd was €201,328.27, compared with €64,654.80 with standard therapy. T-DXd provided 1.24 QALYs (2.24 life years), while standard therapy provided 1.03 QALYs (1.86 life years). The incremental cost-utility ratio (ICUR) for T-DXd compared with standard of care (SOC) was €648,710.32/QALY. For the hormone receptor-positive (RH+) subgroup, the total healthcare cost for patients treated with T-DXd was €204,262.69, compared with €71,596.21 with standard therapy. T-DXd provided 1.33 QALYs (2.46 life years), while standard therapy provided 1.08 QALYs (1.99 life years). The ICUR for T-DXd compared with SOC was €541,758.59/QALY. The estimated 5-year budget impact ranged from €72 million to €140 million for the overall population and €64 million to €124 million for the RH+ subgroup.

Conclusions: Trastuzumab deruxtecan in HER2-low advanced or metastatic breast cancer shows limited cost effectiveness and represents a significant budgetary challenge for the Spanish National Health System, particularly in RH+ patients.

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曲妥珠单抗Deruxtecan治疗her2低晚期或转移性乳腺癌的经济评价

目的：本研究从西班牙国家卫生系统的角度，评估曲妥珠单抗德鲁德康（T-DXd）与标准治疗在先前治疗过的her2低晚期或转移性乳腺癌中的效率和预算影响。方法：采用DESTINY-BREAST04试验数据建立分区生存模型。对总体人群和激素受体阳性（RH+）亚组的健康结果以质量调整生命年（QALYs）衡量。分析是从西班牙国家卫生系统的角度进行的，时间跨度为75个月。采用单变量敏感性分析探讨参数的不确定性。费用来源于西班牙保健数据库和专家意见。结果：在75个月时，对于整个患者群体，接受T-DXd治疗的患者的总医疗保健费用为201,328.27欧元，而标准治疗为64,654.80欧元。T-DXd提供1.24个生命年（2.24个生命年），而标准治疗提供1.03个生命年（1.86个生命年）。与标准护理（SOC）相比，T-DXd的增量成本效用比（ICUR）为648,710.32欧元/QALY。对于激素受体阳性（RH+）亚组，接受T-DXd治疗的患者的总医疗保健费用为204,262.69欧元，而标准治疗为71,596.21欧元。T-DXd提供1.33个生命年（2.46个生命年），而标准治疗提供1.08个生命年（1.99个生命年）。与SOC相比，T-DXd的ICUR为541,758.59欧元/QALY。预计5年的预算影响范围为总体人口7200万至1.4亿欧元，RH+子群体6400万至1.24亿欧元。结论：曲妥珠单抗deruxtecan治疗her2低晚期或转移性乳腺癌的成本效益有限，对西班牙国家卫生系统来说是一个重大的预算挑战，特别是在RH+患者中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

PharmacoEconomics Open Multiple-

CiteScore

3.50

自引率

0.00%

发文量

审稿时长

8 weeks

期刊介绍： PharmacoEconomics - Open focuses on applied research on the economic implications and health outcomes associated with drugs, devices and other healthcare interventions. The journal includes, but is not limited to, the following research areas:Economic analysis of healthcare interventionsHealth outcomes researchCost-of-illness studiesQuality-of-life studiesAdditional digital features (including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations) can be published with articles; these are designed to increase the visibility, readership and educational value of the journal’s content. In addition, articles published in PharmacoEconomics -Open may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand important medical advances.All manuscripts are subject to peer review by international experts. Letters to the Editor are welcomed and will be considered for publication.