Department of Pharmacy, Affiliated Hospital of Nantong University, Nantong, China.
School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.
Front Public Health. 2022 Sep 9;10:942767. doi: 10.3389/fpubh.2022.942767. eCollection 2022.
To assess the economic evaluation of margetuximab plus chemotherapy over trastuzumab plus chemotherapy for women with pretreated ERBB2-positive advanced breast cancer in the United States (US) and China.
Based on the SOPHIA trial, a three-state Markov model was developed to compare the cost and efficacy of margetuximab to trastuzumab for previously treated women with ERBB2-positive advanced breast cancer. The model inputs were derived from existing literature and the US life table. Primary outcomes included lifetime costs in US dollars, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). Deterministic and probabilistic sensitivity analyses were conducted to evaluate the impact of uncertainty.
The base case analyses demonstrated that margetuximab plus chemotherapy had an increasing cost of $68,132 and $20,540 over trastuzumab plus chemotherapy in the US and China, respectively, with a gain of 0.11 and 0.09 QALYs both favored margetuximab. The ICERs for two treatment strategies were $260,176 in the US and $630,777 in China, resulting in a poor cost-effectiveness at their respective threshold of willingness to play. One-way sensitivity analyses showed that the results to be most sensitive to the price of margetuximab and that of trastuzumab. And an 11 and 82% price reduction of margetuximab would make this regimen cost-effective in the US and China, respectively.
In the US and China, margetuximab plus chemotherapy is not likely to be cost-effective for women with pretreated ERBB2-positive advanced breast cancer, whereas price reduction effectively improves insufficient cost-effectiveness.
评估玛格妥昔单抗联合化疗对比曲妥珠单抗联合化疗用于美国（US）和中国经治 ERBB2 阳性晚期乳腺癌女性的经济性。
基于 SOPHIA 试验，建立三状态 Markov 模型，比较玛格妥昔单抗和曲妥珠单抗用于经治 ERBB2 阳性晚期乳腺癌女性的成本-效果。模型输入数据来自现有文献和美国生命表。主要结局包括美元寿命年成本、质量调整寿命年（QALY）和增量成本效果比（ICER）。采用确定性和概率敏感性分析评估不确定性的影响。
基础情况分析显示，玛格妥昔单抗联合化疗在美国和中国的成本分别比曲妥珠单抗联合化疗增加 68132 美元和 20540 美元，玛格妥昔单抗分别增加 0.11 和 0.09 QALY。两种治疗方案的 ICER 在美国为 260176 美元，在中国为 630777 美元，均低于各自意愿支付阈值的成本效果。单因素敏感性分析表明，结果对玛格妥昔单抗和曲妥珠单抗的价格最为敏感。玛格妥昔单抗价格降低 11%和 82%，可使该方案在美国和中国具有成本效果。
在美国和中国，玛格妥昔单抗联合化疗不太可能对经治 ERBB2 阳性晚期乳腺癌女性具有成本效果，而降价可有效提高其不足的成本效果。
