Cost-utility analysis of trastuzumab deruxtecan versus trastuzumab emtansine as second-line treatment for HER2-positive metastatic breast cancer

Gu Shilong; Hao Guo

doi:10.1080/14737167.2026.2718415

August 17, 2026Expert Review of Pharmacoeconomics & Outcomes Research

Cost-utility analysis of trastuzumab deruxtecan versus trastuzumab emtansine as second-line treatment for HER2-positive metastatic breast cancer

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Key Points

Evaluate the cost-effectiveness of second-line trastuzumab deruxtecan versus trastuzumab emtansine for HER2-positive metastatic breast cancer from the perspective of the Chinese healthcare system.
Constructed a partitioned survival model with a 3-week cycle length and a lifetime horizon based on the Asian subgroup of the DESTINY-Breast03 trial.
Calculated quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs), followed by deterministic and probabilistic sensitivity analyses.
Trastuzumab deruxtecan provided an additional 1.45 QALYs at an incremental cost of RMB 499,805 relative to trastuzumab emtansine, producing an ICER of RMB 343,989.08/QALY (95% PI: 320,688.31–352,510.34).
At China's willingness-to-pay threshold of RMB 298,995/QALY, trastuzumab deruxtecan was not cost-effective, achieving a 50% probability of cost-effectiveness only when the threshold reached approximately RMB 340,000/QALY.

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Implication

Decision-analytic model demonstrates that trastuzumab deruxtecan is not cost-effective for HER2-positive metastatic breast cancer in China, suggesting drug price discounts are needed.

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Shilong et al. (2026) studied this question.

synapsesocial.com/papers/6a8563d703308d306e2d746f https://doi.org/10.1080/14737167.2026.2718415

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Cost-utility analysis of trastuzumab deruxtecan versus trastuzumab emtansine as second-line treatment for HER2-positive metastatic breast cancer

Key Points

No abstract yet

Implication

Discussion

Cite This Study

Cost-utility analysis of trastuzumab deruxtecan versus trastuzumab emtansine as second-line treatment for HER2-positive metastatic breast cancer

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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