{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T04:47:06Z","timestamp":1776919626897,"version":"3.51.2"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"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. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sacituzumab tirumotecan (Sac-TMT) has demonstrated survival benefits over chemotherapy in patients with previously treated metastatic triple-negative breast cancer (mTNBC). However, its economic value under different payment contexts in China remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A state-transition (Markov) model was used to estimate lifetime costs and quality-adjusted life-years (QALYs) for Sac-TMT versus single-agent chemotherapy in second-line and later-line mTNBC. Clinical efficacy was derived from a phase III randomized trial, with survival extrapolated using parametric models. Cost\u2013utility and price threshold analyses were conducted using willingness-to-pay (WTP) thresholds defined as three times the per-capita gross domestic product (GDP) at the national level and in economically underdeveloped regions. Scenarios incorporating patient assistance programs were also evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Sac-TMT increased QALYs but incurred substantially higher costs, resulting in incremental cost-effectiveness ratios exceeding both national and regional WTP thresholds at the current list price. To achieve cost-effectiveness, the price of Sac-TMT would need to be reduced to 48.3% of the current list price under the national WTP threshold and to 34.9% under the regional threshold. Although patient assistance programs increased the acceptable price range, Sac-TMT remained unlikely to be cost-effective at the list price. The reimbursed price following the 2025 national health insurance negotiation was markedly below these thresholds, suggesting improved economic value under current reimbursement conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sac-TMT is unlikely to be cost-effective at its current list price for previously treated mTNBC in China. Substantial price reductions and reimbursement strategies may improve its economic value, particularly in economically underdeveloped regions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1786762","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T04:22:32Z","timestamp":1776918152000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost\u2013utility and price threshold analysis of sacituzumab tirumotecan versus single-agent chemotherapy for previously treated metastatic triple-negative breast cancer in China"],"prefix":"10.3389","volume":"14","author":[{"given":"Liman","family":"Huo","sequence":"first","affiliation":[{"name":"Department of Pharmacy, The Fourth Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaojie","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Fourth Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Fourth Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yajing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Fourth Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haoyang","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Ultrasound, Fourth Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rong","family":"Guo","sequence":"additional","affiliation":[{"name":"Office of Academic Affairs, The Third Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Fourth Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, The Fourth Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2429","DOI":"10.1097\/CM9.0000000000003278","article-title":"Incidence, mortality, and disability-adjusted life years of female breast cancer in China, 2022","volume":"137","author":"Sun","year":"2024","journal-title":"Chin Med J"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1038\/s41523-022-00468-0","article-title":"Triple-negative breast cancer: pitfalls and progress","volume":"8","author":"Zagami","year":"2022","journal-title":"NPJ Breast Cancer"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"921","DOI":"10.1177\/1060028020966548","article-title":"Sacituzumab govitecan-hziy: an antibody\u2013drug conjugate for the treatment of refractory metastatic triple-negative breast cancer","volume":"55","author":"Seligson","year":"2021","journal-title":"Ann Pharmacother"},{"key":"ref5","first-page":"209","article-title":"Interpretation of key updates in the Chinese Society of Clinical Oncology (CSCO) breast Cancer guidelines 2025","volume":"17","author":"Zhang","year":"2025","journal-title":"Chin J Oncol Surg"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1969","DOI":"10.1038\/s41591-025-03630-w","article-title":"Sacituzumab tirumotecan in previously treated metastatic triple-negative breast cancer: a randomized phase 3 trial","volume":"31","author":"Yin","year":"2025","journal-title":"Nat Med"},{"key":"ref7","volume-title":"NCCN Clinical Practice Guidelines in Oncology: Breast Cancer. 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