Cost-effectiveness analysis of tucatinib plus trastuzumab versus pertuzumab plus trastuzumab for chemotherapy-refractory, HER2-positive, RAS wild-type unresectable or metastatic colorectal cancer

BACKGROUND: This study evaluates the cost-effectiveness of tucatinib plus trastuzumab compared to pertuzumab plus trastuzumab for chemotherapy-refractory, HER2-positive, RAS wild-type unresectable or metastatic colorectal cancer (CRC) from the perspective of healthcare payers in China. RESEARCH DESIGN AND METHODS: An economic evaluation utilizing a 3-state partitioned survival model assessed the cost-effectiveness of tucatinib plus trastuzumab versus pertuzumab plus trastuzumab. RESULTS: When the price of tucatinib was based on that of lapatinib in China, the estimated cost for tucatinib plus trastuzumab was higher than that of pertuzumab plus trastuzumab (29,130.32 USD vs 12,160.58 USD). The estimated utility was also greater compared to that of pertuzumab plus trastuzumab (2.07 QALYs vs 1.07 QALYs). The ICER was calculated at 17,075.25 USD/QALY, suggesting the tucatinib plus trastuzumab treatment was cost-effective compared to pertuzumab plus trastuzumab for chemotherapy-refractory, HER2-positive, RAS wild-type unresectable or metastatic CRC at a WTP threshold of 40,000 USD/ QALY. CONCLUSIONS: Tucatinib plus trastuzumab was cost-effective if its price was the same as lapatinib for chemotherapy-refractory, HER2-positive, RAS wild-type unresectable or metastatic CRC from the perspective of healthcare payers in China. Our exploratory result could provide a reference for clinical application of tucatinib plus trastuzumab when they are correctly interpreted.