ASCENT试验证明了sacituzumab govitecan对于治疗晚期或转移性三阴性乳腺癌（TNBC）的疗效。本研究从美国支付方的角度评估了接受sacituzumab govitecan与接受标准护理化疗的费效比。采用分割存活方法来预测晚期或转移性TNBC的病程。分析了两组不同患者的存活模式。存活数据来自ASSENT试验。直接医疗成本来源于美国医疗保险和医疗补助中心的数据。效用数据收集自已发表的文献。增量成本效益比（ICUR）是衡量治疗方案费效比的主要结局。采用单向敏感性和概率敏感性分析来探索不确定性并验证结果的稳定性。 在基准情况下，采用经典存活模式设置时，sacituzumab govitecan与化疗相比的ICUR为$ 778,771.9/QALY和$ 702,281/QALY，分别适用于整个人群和无脑转移的人群。然而在巨细胞网状内皮瘤细胞（MES）治愈的存活模式下，ICUR为整个人群为$ 506,504.5/QALY，无脑转移人群为$ 274,232.0/QALY。单向敏感性分析显示，sacituzumab govitecan的单位成本和体重是降低ICUR值的关键因素。概率敏感性分析还显示，降低sacituzumab govitecan的单价可以提高其成本效益比。 本次费效度分析表明，从美国支付方的角度来看，以目前的价格，sacituzumab govitecan不太可能成为晚期或转移性TNBC患者的首选治疗方案，其费效比阈值为每QALY 15万美元。版权所有©2023作者。由Elsevier Ltd.出版。保留所有权利。

The ASCENT trial demonstrated the efficacy of sacituzumab govitecan for the treatment of advanced or metastatic triple-negative breast cancer (TNBC). The current study evaluated the cost-effectiveness of receiving sacituzumab govitecan compared with standard of care chemotherapy from the United States payer perspective.A partitioned survival approach was used to project the disease course of advanced or metastatic TNBC. Two survival modes were applied to analyze two groups of patients. The survival data were gathered from the ASCENT trial. Direct medical costs were derived from the data of Centers for Medicare & Medicaid Services. Utility data was collected from the published literature. The incremental cost-utility ratio (ICUR) was the primary outcome that measured the cost-effectiveness of therapy regimen. One-way sensitivity and probabilistic sensitivity analysis were implemented to explore the uncertainty and validate the stability of results.In the base-case, the ICUR of sacituzumab govitecan versus chemotherapy is $ 778,771.9/QALY and $ 702,281/QALY for full population group and brain metastatic-negative (BMN) group with the setting of classic survival mode. And in the setting of cure survival mode, the ICUR is $ 506,504.5/QALY for the full population group and $ 274,232.0/QALY for BMN population group. One-way sensitivity analyses revealed that the unit cost of sacituzumab govitecan and body weight were key roles that lower the ICUR value. Probabilistic sensitivity analyses also showed that reducing the unit price of sacituzumab govitecan can improve the likelihood of becoming cost-effective.The cost-effectiveness analysis suggested that from a US payer perspective, sacituzumab govitecan at current price is unlikely to be a preferred option for patients with advanced or metastatic TNBC at a threshold of $ 150,000/QALY.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.