Inano Hiroshi, Morimoto Yoshihito, Kitagawa Kanata, Shibuya Akito, Nakagomi Kozue, Ota Tomohiro, Anzo Yuri, Miyauchi Rika, Shono Aiko, Watanabe Kazuhiro, Otori Katsuya
Department of Pharmacy, Kitasato University Hospital, 1-15-1, Kitasato, Sagamihara, Minami, 252-0375, Japan.
Education and Research Center for Clinical Pharmacy, Showa Pharmaceutical University, 3-3165 Higashi-Tamagawagakuen, Machida, Tokyo, 194-8543, Japan.
Support Care Cancer. 2025 Feb 4;33(2):149. doi: 10.1007/s00520-025-09210-5.
Our previous study showed that the preventive effects of fosnetupitant (F-NTP) against chemotherapy-induced nausea and vomiting (CINV) were superior to those of fosaprepitant (F-APR) or aprepitant (APR). To evaluate the cost-effectiveness of F-NTP compared with F-APR or APR in Japan, a cost-utility analysis was performed.
A decision tree model was developed based on real-world data to compare the CINV prevention ability of each neurokinin-1 receptor antagonist (NK RA) in Japanese patients receiving cisplatin-based regimens. We evaluated the patients 7 days after the first course of treatment. Quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) were calculated to examine the cost-effectiveness of the antiemetic therapy. The probabilities of health states and medical costs were derived from the results of our previous study. These cost-utility analyses were performed from the perspective of the payers.
The incremental QALYs of F-NTP relative to F-APR and APR were 0.00180 and 0.00153, respectively. The ICER of F-NTP relative to F-APR was 22,802.21 US dollars (USD) per QALY gained, which was lower than the willingness-to-pay (WTP) threshold (38,043.06 USD: 5 million Japanese Yen/QALY). Contrastingly, the ICER of F-NTP relative to APR was 40,119.64 USD/QALY, which was slightly above the WTP threshold, indicating that F-NTP may be slightly less cost-effective.
F-NTP is more cost-effective than F-APR, but slightly less cost-effective than APR.
我们之前的研究表明，福沙吡坦（F-NTP）对化疗引起的恶心和呕吐（CINV）的预防效果优于福沙匹坦（F-APR）或阿瑞匹坦（APR）。为了评估在日本F-NTP与F-APR或APR相比的成本效益，进行了成本效用分析。
基于真实世界数据建立决策树模型，以比较接受顺铂方案的日本患者中每种神经激肽-1受体拮抗剂（NK RA）预防CINV的能力。我们在首个疗程治疗7天后对患者进行评估。计算质量调整生命年（QALY）和增量成本效益比（ICER），以检验止吐治疗的成本效益。健康状态概率和医疗成本来自我们之前的研究结果。这些成本效用分析是从支付方的角度进行的。
F-NTP相对于F-APR和APR的增量QALY分别为0.00180和0.00153。F-NTP相对于F-APR的ICER为每获得一个QALY22,802.21美元（USD），低于支付意愿（WTP）阈值（38,043.06美元：500万日元/QALY）。相反，F-NTP相对于APR的ICER为40,119.64美元/QALY，略高于WTP阈值，表明F-NTP的成本效益可能略低。
F-NTP比F-APR更具成本效益，但比APR的成本效益略低。
