Objective: This study evaluated the cost-effectiveness of sacituzumab govitecan (SG) compared with single-agent chemotherapy of the physician’s choice (TPC) from the perspective of Taiwan’s National Health Insurance. Methods: A partitioned survival model was developed to assess outcomes in patients with metastatic triple-negative breast cancer (mTNBC). Clinical data were derived from the ASCENT trial, while direct medical costs were obtained from Taiwan’s National Health Insurance Administration (NHIA). Utility values were taken from published literature. The primary outcome was the incremental cost-effectiveness ratio (ICER), expressed as cost per quality-adjusted life year (QALY) gained. One-way and probabilistic sensitivity analyses were performed to examine parameter uncertainty and test the robustness of the results. Results: In the base-case analysis, SG was associated with an incremental cost of USD 121,836 per QALY gained—exceeding Taiwan’s willingness-to-pay (WTP) threshold of USD 102,120. One-way sensitivity analyses indicated that SG drug cost was the primary driver of ICER variability. Probabilistic sensitivity analysis showed that reducing the price of SG by 50% increased the likelihood of cost-effectiveness. Conclusions: From the NHIA perspective, SG is not cost-effective for patients with advanced or metastatic TNBC at its current price. Substantial price reductions would be required for SG to become cost-effective under the WTP threshold of USD 102,120 per QALY.
目的：本研究从台湾全民健康保险的视角，评估了戈沙妥珠单抗（SG）与医生选择的单药化疗（TPC）相比的成本效益。方法：构建分区生存模型，评估转移性三阴性乳腺癌（mTNBC）患者的治疗结果。临床数据来源于ASCENT试验，直接医疗成本取自台湾卫生福利部中央健康保险署（NHIA），效用值则参考已发表文献。主要结局指标为增量成本效益比（ICER），以每获得一个质量调整生命年（QALY）的成本表示。通过单因素敏感性分析和概率敏感性分析检验参数不确定性及结果稳健性。结果：在基础案例分析中，SG的增量成本效益比为每获得一个QALY需增加121,836美元，超过台湾102,120美元的支付意愿阈值。单因素敏感性分析显示SG药品成本是影响ICER变异性的主要因素。概率敏感性分析表明，将SG价格降低50%可显著提高其成本效益可能性。结论：从NHIA视角看，按当前价格，SG对于晚期或转移性TNBC患者不具有成本效益。若要使SG在每QALY 102,120美元的支付意愿阈值下实现成本效益，需要对其价格进行大幅下调。
肿瘤(癌症)患者之家