{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:47:56Z","timestamp":1782362876912,"version":"3.54.5"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T00:00:00Z","timestamp":1782345600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study assessed the cost-effectiveness of pyrotinib combined with trastuzumab and docetaxel as a first-line treatment for HER2-positive metastatic breast cancer from the perspective of the Chinese healthcare system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A partitioned survival model was constructed to evaluate the cost-effectiveness of this regimen in patients with HER2-positive metastatic breast cancer. The primary outcomes were total costs, quality-adjusted life-years (QALYs), and the incremental cost-effectiveness ratio (ICER). The treatment strategy was considered cost-effective when the ICER fell below a predefined willingness-to-pay (WTP) threshold. One-way and probabilistic sensitivity analyses were conducted to address parameter uncertainties. Additional scenario analyses were performed to explore how different assumptions influenced the ICER.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the base-case analysis, the pyrotinib group incurred total costs of $136,400.69 compared with $83,887.55 in the placebo group. The corresponding effectiveness was 5.20 QALYs\n                      <jats:italic>versus<\/jats:italic>\n                      3.89 QALYs. The ICER was $40,245.81\/QALY, which exceeded the WTP threshold (two times China\u2019s per capita GDP in 2025, $27,906.03\/QALY). One-way sensitivity analysis revealed that utility of progression-free survival and the price of pyrotinib were the most influential factors on the ICER. Probabilistic sensitivity analysis indicated that at the WTP threshold of $27,906.03\/QALY, pyrotinib had a 6.1% probability of being cost-effective. Scenario analyses confirmed the robustness of the model. Price threshold analysis showed that the price of pyrotinib would need to be reduced by more than 34.45% to bring the ICER below the WTP threshold.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>From the Chinese healthcare perspective, pyrotinib combined with trastuzumab and docetaxel may not be cost-effective for HER2-positive metastatic breast cancer under current prices and the WTP threshold. A price reduction would be required to achieve cost-effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2026.1845724","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:21:27Z","timestamp":1782361287000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-effectiveness analysis of pyrotinib combined with trastuzumab and docetaxel as first-line treatment for HER2-positive metastatic breast cancer in China"],"prefix":"10.3389","volume":"17","author":[{"given":"Miao","family":"Liang","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Hebei Medical University Third Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sisi","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hebei Medical University Third Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hebei Medical University Third Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianna","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Hebei Medical University Third Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"6053","DOI":"10.3390\/curroncol29090476","article-title":"Cost-effectiveness of pyrotinib plus capecitabine versus lapatinib plus capecitabine for the treatment of HER2-Positive metastatic breast cancer in China: a scenario analysis of health insurance coverage","volume":"29","author":"Bao","year":"2022","journal-title":"Curr. 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