Rezaei, Mohammad Ali and Pourasghari, Hamid and Karimi, Fereshte and Behzadifar, Masoud (2025) Economic evaluation of antibody-drug conjugates (ADCs) in patients with breast cancer: systematic review. Eur J Clin Pharmacol.
Full text not available from this repository.Abstract
Introduction: Metastatic breast cancer (mBC) is a major global health challenge. Antibody-drug conjugates (ADCs), including trastuzumab emtansine (T-DM1), trastuzumab deruxtecan (T-DXd), and sacituzumab govitecan (SG), offer clinical benefits but are associated with high costs, making cost-effectiveness assessments essential for policy decisions. Methods: This systematic review analyzed economic evaluations comparing T-DM1, T-DXd, and SG with conventional treatments in breast cancer. A search of four databases and gray Literature up to November 2024 included studies reporting ICERs, QALYs, and LYGs. Data were extracted per PRISMA and CHEERS guidelines. Results: Twenty-nine studies from the USA, China, Brazil, Germany, Finland, Singapore, and Canada were reviewed. In the USA, ICERs for T-DXd ranged from $194,424/QALY (HR-) to $406,900/QALY, often exceeding WTP thresholds ($100K-$200K). It was cost-effective in HR- patients and those with good ECOG. In China, ICERs > $50,000/QALY exceeded the national threshold (~ $36,475/QALY). In Finland, T-DXd was cost-effective vs. T-DM1 (€55,360/QALY). T-DM1 was cost-effective in Canada (-$3,844/QALY) and select U.S. studies, but not in Brazil ($99,699/QALY) or China. Drug pricing was a key driver; U.S. results varied, perhaps due to modeling differences and sponsor bias. SG was not cost-effective in any country. ICERs ranged from $237,816/QALY (Singapore) to > $1.3 million/QALY (USA). In China, the cost-effectiveness probability was 0% at current prices. Conclusion: T-DXd and T-DM1 may be cost-effective in select groups and high-income countries. SG is not cost-effective anywhere. Drug prices are the main determinant of value, highlighting the need for price negotiations and more regional studies
| Item Type: | Article |
|---|---|
| Subjects: | R Medicine > RZ Other systems of medicine |
| Divisions: | Faculty of Medicine, Health and Life Sciences > School of Medicine |
| Depositing User: | lorestan university |
| Date Deposited: | 14 Sep 2025 07:55 |
| Last Modified: | 14 Sep 2025 07:55 |
| URI: | http://eprints.lums.ac.ir/id/eprint/5212 |
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