Department of Oncology, Mater Salutis Hospital , Legnago , VR , Italy.
Expert Rev Pharmacoecon Outcomes Res. 2019 Oct;19(5):505-508. doi: 10.1080/14737167.2019.1650644. Epub 2019 Aug 4.
The analysis was conducted to assess a cost-efficacy analysis of new antiemetic drugs (netupitant plus palonosetron (NEPA)) for the prophylaxis of chemotherapy-induced nausea and vomiting (CINV) in highly and moderately emetogenic chemotherapy for cancer treatment. The present evaluation was restricted to pivotal phase III randomized controlled trials (RCTs) of NEPA versus (vs.) palonosetron for the prophylaxis of CINV. We calculated the pharmacological costs necessary to get the benefit in complete response (CR), for each trial. Our analysis evaluated 2 RCTs, including 1720 patients. Referring to both highly and moderately emetogenic chemotherapy, NEPA plus DEX was economic superior to palonosetron (PALO) plus DEX, with 13 312 € and 7885 € gain in medical costs every 100 patients treated, respectively. The cost-effectiveness ratios (CERs) (€/CR) in highly emetoge nic risk were 1.24 and 13.23 for the NEPA and PALO group, respectively and 1.49 and 15.20 for the same groups in moderately emetogenic risk. The incremental cost-effectiveness ratio (ICER) between the groups was 1016.18 €/CR and 1024.03 €/CR in highly and moderately emetogenic risk, respectively. The combination of NEPA plus DEX is cost-effective for preventing CINV in highly and moderately (AC-based) emetogenic cancer treatment.
本分析旨在评估新型止吐药物（奈妥匹坦联合帕洛诺司琼（NEPA））用于预防癌症治疗中高和中度致吐性化疗引起的化疗诱发恶心和呕吐（CINV）的成本效益分析。本评估仅限于 NEPA 与帕洛诺司琼（PALO）预防 CINV 的关键性 III 期随机对照试验（RCT）。我们计算了每个试验中获得完全缓解（CR）的获益所需的药理学成本。我们的分析评估了 2 项 RCT，共纳入 1720 例患者。对于高和中度致吐性化疗，NEPA 联合地塞米松（DEX）在经济性方面优于 PALO 联合 DEX，每 100 例治疗患者分别节省 13312 欧元和 7885 欧元的医疗费用。在高致吐风险中，NEPA 和 PALO 组的成本效益比（CER）（欧元/CR）分别为 1.24 和 13.23，在中度致吐风险中，这两个组的 CER 分别为 1.49 和 15.20。两组间的增量成本效益比（ICER）分别为高和中度致吐风险中的 1016.18 欧元/CR 和 1024.03 欧元/CR。在高和中度（基于 AC）致吐性癌症治疗中，NEPA 联合 DEX 预防 CINV 具有成本效益。
