ArticleFrontiers in public health2026
Cost-effectiveness analysis of sacituzumab tirumotecan vs. chemotherapy for patients with EGFR-TKI-resistant, EGFR-mutated advanced non-small cell lung cancer in China.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: In the OptiTROP-Lung04 trial, sacituzumab tirumotecan (sac-TMT) yielded a median progression-free survival of 8.3 months-a clinically significant outcome that has approval by the National Medical Products Administration. This study evaluates the cost-effectiveness of sac-TMT as a later-line therapy for patients with EGFR-mutant advanced NSCLC who have progressed on EGFR-TKIs, from the perspective of Chinese healthcare system. Methods: A partitioned survival model was constructed to simulate patients' health state transitions in 28-day cycles and predict long-term survival and economic outcomes over a 10-year time horizon for the two treatment strategies. Clinical data were sourced from the OptiTROP-Lung04 trial, whereas cost and utility parameters were extracted from local medical charges and published literatures. The model calculated total costs, life-years (LYs), quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio (ICER). One-way and probabilistic sensitivity analyses were conducted to verify the robustness of model outputs. Scenario analyses evaluated changes in the ICER under different sac-TMT price levels and alternative time horizons. Subgroup analyses estimated ICER values corresponding to hazard ratios across distinct subgroups. Results: Compared with the chemotherapy group, sac-TMT incurred an incremental cost of $28,285.28 and generated an additional 0.84 QALYs and 1.74 LYs, yielding an ICER of $33,514.79/QALY. One-way sensitivity analysis revealed that cost of sac-TMT, progression-free survival (PFS) utility value, and discount rate were the three parameters exerting the strongest influence on the ICER. Probabilistic sensitivity analysis indicated that sac-TMT had a 23.90% probability of being cost-effective. Scenario analysis demonstrated that the ICER would precisely hit the cost-effectiveness threshold ($27,906.03/QALY) if the unit price of sac-TMT decreased to $541.55/200 mg. Conclusions: Based on this analytical model, sac-TMT is unlikely to be cost-effective for Chinese patients with EGFR-TKI-resistant, EGFR-mutated advanced NSCLC. Nevertheless, a further price reduction of 14.98% would make it cost-effective.
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