alternatives examined?
Yes
Partial evaluation
Cost-outcome description
Cost-minimisation analysis
Cost-effectiveness analysis
Cost–utility analysis
Cost–benefit analysis
means that, in order to assess the
costs of managing nausea and
vomiting episodes induced by
chemotherapy, not only the cost
of the innovative pharmaceutical
treatment but also any eventual
savings due to its introduction (for
example, reduced hospitalisations
or increasing productivity at
work) need to be included.
Pharmacoeconomic evaluations
comparing treatments of CINV
can be performed in different
settings (for example, inpatient
or outpatient), involving different
target patients and adopting
mostly a societal, provider or payer
perspective, although the societal
one should always be preferred.
A cost-effectiveness study of
NEPA (oral fixed combination
of netupitant 300mg and
palonosetron 0.5mg) compared it
with four currently recommended
triple-agent antiemetics to prevent
CINV in patients undergoing
treatment with highly emetogenic
chemotherapy in Germany and
Greece. 15 Comparators were
apreptitant (Apr) + ondansetron
(Ond), Apr + palonosetron (Pal),
fosaprepitant (Fos) + granisetron
(Gra) and rolapitant (Rol) + Gra
(only for Germany). A Markov
model was developed to estimate
the cost-effectiveness of NEPA on
a five-day period, corresponding
to the overall CINV phase, using
the German health-care payer
perspective. Direct healthcare
costs considered were related to
antiemetic drugs and management
of episodes of CINV.
Results showed that NEPA
is a cost-effective strategy for
prevention of CINV. Total cost
of NEPA was €81.49 and it was
the most effective with a total
of 4.272 quality adjusted life days
(QALDs; the primary outcome).
The differential total costs were
+€35.45, +€37.38, +€68.77 and
+€6.89 for Apr+Ond, Apr+Pal,
Fos+Gra and Rol+Gra, respectively.
The total differential QALDs
were -0.0004, -0.0001, -0.0004 and
-0.0006, respectively. Proportions of
CINV-free patients at five days (the
secondary outcome) were 83.0% for
NEPA and 79.4%, 83.0%, 79.1% and
75.5% for the comparators. NEPA
was also dominant against all
three comparators in Greece,
hospitalpharmacyeurope.com | 2018 | 49