Lordick Florian, Ehlken Birgit, Ihbe-Heffinger Angela, Berger Karin, Krobot Karl J, Pellissier James, Davies Glenn, Deuson Robert
Third Medical Department, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany.
Eur J Cancer. 2007 Jan;43(2):299-307. doi: 10.1016/j.ejca.2006.09.019. Epub 2006 Nov 28.
Chemotherapy-induced nausea and vomiting (CINV) remains a major adverse effect of cancer therapy. We aimed to determine outcomes associated with use of aprepitant in outpatients undergoing highly emetogenic chemotherapy in Germany from a patient's and payer's perspective.
A decision-analytic model compared an aprepitant regimen (aprepitant/ondansetron/dexamethasone) to a control regimen (ondansetron/dexamethasone) over a five days period. Clinical results and resource utilisation observed in aprepitant phase III clinical trials were assigned German unit cost data.
Complete response over one chemotherapy cycle was observed in 68% of patients in the aprepitant group (N=514) compared to 48% of patients in the control group (N=518). Patients were estimated to have gained an equivalent of 15 additional hours of perfect health per cycle (0.63 quality-adjusted life days) with aprepitant-based regimen compared to control regimen. Cost per quality-adjusted life year gained with aprepitant was estimated at euro28,891.
Aprepitant substantially improved CINV-related health outcomes in patients undergoing highly emetogenic chemotherapy. Incremental benefits materialised in a cost-effective fashion.
化疗引起的恶心和呕吐(CINV)仍然是癌症治疗的主要不良反应。我们旨在从患者和支付方的角度确定在德国接受高致吐性化疗的门诊患者中使用阿瑞匹坦的相关结果。
一个决策分析模型在五天的时间内将阿瑞匹坦方案(阿瑞匹坦/昂丹司琼/地塞米松)与对照方案(昂丹司琼/地塞米松)进行了比较。在阿瑞匹坦III期临床试验中观察到的临床结果和资源利用情况被赋予了德国单位成本数据。
阿瑞匹坦组(N = 514)68%的患者在一个化疗周期内观察到完全缓解,而对照组(N = 518)为48%。与对照方案相比,估计使用基于阿瑞匹坦的方案的患者每个周期可多获得相当于15个额外小时的完美健康状态(0.63个质量调整生命日)。使用阿瑞匹坦获得每质量调整生命年的成本估计为28,891欧元。
阿瑞匹坦显著改善了接受高致吐性化疗患者与CINV相关的健康结果。增量效益以具有成本效益的方式实现。