{
  "abstract": "BackgroundThe phase III TROPION-Breast02 trial demonstrated improved progression-free and overall survival with datopotamab deruxtecan (Dato-DXd) versus chemotherapy in patients with previously untreated advanced triple-negative breast cancer who were ineligible for immunotherapy. This study evaluated the cost-effectiveness of Dato-DXd from the perspectives of the United States (U.S.) and Chinese healthcare systems.MethodsA three-state partitioned survival model was developed using TROPION-Breast02 data, with a 10-year horizon and 21-day cycles. Costs and utilities were obtained from public databases and published literature. The primary outcome was the incremental cost-effectiveness ratio (ICER), expressed as cost per quality-adjusted life-year (QALY) gained. Willingness-to-pay thresholds were $150,000/QALY in the U.S. and $27,906/QALY in China. Sensitivity and scenario analyses assessed uncertainty and the robustness of the findings, and exploratory subgroup analyses were performed.ResultsCompared with chemotherapy, Dato-DXd increased costs by $565,572.29 and QALYs by 0.44 in the U.S., yielding an ICER of $1,287,001.65/QALY. In China, the corresponding increases were $39,052.50 and 0.42 QALYs, yielding an ICER of $92,640.82/QALY. Price reductions of approximately 62.43% in the U.S. and 28.83% in China were required to reach the respective cost-effectiveness thresholds. Progression-free survival utility and Dato-DXd price were the most influential parameters in one-way sensitivity analyses. In exploratory scenario analyses, limiting treatment duration to the reported median yielded cost-effective results in both countries. Assuming unchanged efficacy, a hypothetical reduction in the Dato-DXd dose from 6 to 4 mg/kg made it cost-effective in China but not in the U.S. Exploratory subgroup analyses yielded conclusions consistent with the base-case findings.ConclusionAt the modeled prices and under the base-case assumptions, Dato-DXd was not cost-effective compared with chemotherapy in either country. Price reductions could improve its cost-effectiveness. Results were sensitive to assumptions about treatment duration. The potential economic benefits of reduced-dose or fixed-duration strategies depend on clinical confirmation of maintained efficacy and acceptable safety.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "Original Research",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "name": "Zuojuan Xiang"
    },
    {
      "name": "Qiao Xia"
    },
    {
      "name": "Zhengxiong Li"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/ftdgrmthvn8nf.bib",
  "cited_by": 0,
  "doi": "10.3389/fphar.2026.1965457",
  "fulltext_url": null,
  "id": "ftdgrmthvn8nf",
  "issns": [
    "1663-9812"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1965457",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "feed-journal",
      "medicine/pharmacology-toxicology"
    ]
  ],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-06",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/ftdgrmthvn8nf.ris",
  "sources": [
    {
      "first_seen": "2026-11-06T06:20:06Z",
      "native_id": "10.3389/fphar.2026.1965457",
      "source": "feed-frontiers",
      "url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1965457"
    },
    {
      "first_seen": "2026-11-06T12:21:21Z",
      "native_id": "10.3389/fphar.2026.1965457",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1965457/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "feed-journal:medicine/pharmacology-toxicology",
      "subfield": "pharmacology-toxicology"
    }
  ],
  "title": "Cost-effectiveness of datopotamab deruxtecan versus chemotherapy as a first-line treatment for patients with advanced triple-negative breast cancer",
  "title_text": "Cost-effectiveness of datopotamab deruxtecan versus chemotherapy as a first-line treatment for patients with advanced triple-negative breast cancer",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T00:23:04Z",
  "url": "https://research.draconitic.com/paper/ftdgrmthvn8nf",
  "venue": "Frontiers in Pharmacology",
  "versions": []
}