Cost-effectiveness analysis of antiemetic treatment.
To address the economic issues posed by the introduction of 5-hydroxytryptamine3 receptor antagonist (5-HT3 RA), we performed a cost-effectiveness analysis based on clinical trial data published in the recent literature. Cost calculations include initial treatment and a second-line salvage treatment. The average cost and incremental cost were established. Incremental cost corresponds to the extra cost involved in achieving total control of emesis in 1% extra patients. If 5-HT3 RA is not part of the initial treatment, salvage treatment with ondansetron is not cost-effective. Moreover, starting with the combination of ondansetron plus dexamethasone saves more money than starting with ondansetron alone. However, if the difference in emesis control is only minimal, treatment with the 5-HT3 RA remains more expensive.
Chemotherapy Unit, Institut Jules Bordet, Bruxelles, Belgium.
H
H
Bleiberg
P
P
Autier
D
D
Michaux
D000932:Antiemetics / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D005060:Europe; D005062:European Union; D006801:Humans; D008140:Lorazepam / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D008787:Metoclopramide / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D017294:Ondansetron / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D016879:Salvage Therapy; D012702:Serotonin Antagonists / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D014839:Vomiting / Q000191:economics / Q000517:prevention & control*
D000932:Antiemetics; D012702:Serotonin Antagonists; D017294:Ondansetron; D003907:Dexamethasone; D008787:Metoclopramide; D008140:Lorazepam