Evidence map›Paper›PMID 40925932›Full record

SynthesisEuropean journal of clinical pharmacology2025

Economic evaluation of antibody-drug conjugates (ADCs) in patients with breast cancer: systematic review.

Mohammad Ali Rezaei, Hamid Pourasghari, Fereshte Karimi, Soheila Rajaie, Amirreza Shahmohammady, Masoud Behzadifar, Amir Hossein Dehqan, Samad Azari

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of clinical pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Mohammad Ali RezaeiHospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
Hamid PourasghariHospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
Fereshte KarimiResearch Center for Emergency and Disaster Resilience, Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran.
Soheila RajaieDepartment of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Amirreza ShahmohammadyHospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.
Masoud BehzadifarSocial Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran.
Amir Hossein DehqanSchool of Biological Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran.
Samad AzariHospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran. Samadazari1010@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMetastatic 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.

methodsThis 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.

resultsTwenty-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.

conclusionT-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.

Indexed as

Antineoplastic Agents, ImmunologicalBreast NeoplasmsImmunoconjugatesAdo-Trastuzumab EmtansineAntibodies, Monoclonal, HumanizedCamptothecinCost-Benefit AnalysisFemaleHumansQuality-Adjusted Life YearsTrastuzumabAdo-Trastuzumab EmtansineAntibodies, Monoclonal, HumanizedAntineoplastic Agents, ImmunologicalCamptothecinImmunoconjugatessacituzumab govitecanTrastuzumabBreast cancerEconomic evaluationSacituzumab govitecanTrastuzumab deruxtecanTrastuzumab emtansine

Identifiers

PMID40925932

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.