This study evaluates the cost-effectiveness of sacituzumab govitecan (SG) versus chemotherapy for hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-) metastatic breast cancer (BC) from a US third-party payer perspective. Using a partitioned survival model with data from the TROPiCS-02 trial, the analysis found that while SG increased life-years and QALYs, the high cost resulted in an ICER of $612,772/QALY, making it not cost-effective at a WTP threshold of $150,000/QALY. Sensitivity analyses showed cost-effectiveness is sensitive to SG price and patient weight. Subgroup analyses confirmed the lack of cost-effectiveness across various patient subgroups. The study concludes that SG's high price is a significant barrier to cost-effectiveness, suggesting price reduction is necessary to improve its feasibility.

Demin Shi, Yan Li, Xueyan Liang, Lingyuan Chen