Cost-effectiveness of datopotamab deruxtecan in previously treated advanced nonsquamous NSCLC

Background: To evaluate the cost-effectiveness of datopotamab deruxtecan (Dato-DXd) in patients with previously treated advanced nonsquamous non-small-cell lung cancer from the perspective of a payer in the United States. Methods: A partitioned survival model with 3 states was employed to simulate patients receiving Dato-DXd or docetaxel (Dato-DXd or docetaxel group). The data on cost and health preferences were collected from the literature. Results: The Dato-DXd group generated an additional 0.11 quality-adjusted life years (QALYs) compared with the docetaxel group but at an additional cost of $119,575. This leads to incremental cost-effectiveness ratios of $1,054,809 per QALY. The results of the univariate sensitivity analysis indicated that the cost of Dato-DXd, the utility of progression-free survival, and progressive disease had the greatest impacts on the outcomes. The probability sensitivity analysis showed that Dato-DXd had a 0% chance of being considered cost-effective. When the cost of Dato-DXd decreased to 0.116 times the current price, the incremental cost-effectiveness ratio would decrease to a level below the willingness-to-pay threshold of $150,000/QALY. Conclusion: In our model, from the perspective of a U.S. payer, Dato-DXd was not considered cost-effective for previously treated advanced nonsquamous non-small-cell lung cancer at a willingness-to-pay threshold of $150,000/QALY. This underscores the importance of assessing the cost-effectiveness of new treatments in the context of limited healthcare resources. Given the escalating costs of cancer care and the increasing demand for efficacious therapies, it is imperative that policymakers take into account not only the immediate costs of treatments but also their wider, long-term repercussions on patient outcomes and the sustainability of the healthcare system.