{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T05:00:37Z","timestamp":1785128437440,"version":"3.55.0"},"reference-count":51,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100020439","name":"Jiangsu Pharmaceutical Association","doi-asserted-by":"publisher","award":["H202137"],"award-info":[{"award-number":["H202137"]}],"id":[{"id":"10.13039\/100020439","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007289","name":"Nanjing Medical University","doi-asserted-by":"publisher","award":["KD2024KYJJ058"],"award-info":[{"award-number":["KD2024KYJJ058"]}],"id":[{"id":"10.13039\/501100007289","id-type":"DOI","asserted-by":"publisher"}]}],"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>In the OptiTROP-Lung04 trial, sacituzumab tirumotecan (sac-TMT) yielded a median progression-free survival of 8.3 months\u2014a 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Based on this analytical model, sac-TMT is unlikely to be cost-effective for Chinese patients with EGFR-TKI\u2013resistant, EGFR-mutated advanced NSCLC. Nevertheless, a further price reduction of 14.98% would make it cost-effective.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1843636","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T04:25:50Z","timestamp":1785126350000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-effectiveness analysis of sacituzumab tirumotecan vs. chemotherapy for patients with EGFR-TKI\u2013resistant, EGFR-mutated advanced non-small cell lung cancer in China"],"prefix":"10.3389","volume":"14","author":[{"given":"Kai","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Nanjing Qixia Community Healthcare Center","place":["Nanjing, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuting","family":"Yan","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Emotions and Affective Disorders, 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