In:
Cancer Science, Wiley, Vol. 109, No. 9 ( 2018-09), p. 2881-2888
Abstract:
Chemotherapy‐induced nausea and vomiting ( CINV ) remains a major adverse event in cancer chemotherapy. Although aprepitant is effective in preventing CINV , an increment in financial burden for uniform use of aprepitant is a concern. The aim of the present study was to define the cost‐effectiveness of aprepitant from the perspective of the Japanese National Health Insurance system. Based on the results of a randomized phase II trial comparing an aprepitant‐containing regimen versus a nonaprepitant regimen in Japanese patients who received cisplatin‐containing highly emetogenic chemotherapy, a decision analytic model was developed. The incremental cost‐effectiveness ratio ( ICER ) was calculated both in the outpatient care setting ( OCS ) and in the inpatient care setting ( ICS ). The use of the aprepitant‐containing regimen was associated with improved quality of life compared with the nonaprepitant regimen, with an increment in quality‐adjusted life years ( QALY ) of 0.0016. The incremental total medical costs associated with the use of the aprepitant regimen were lower in the OCS than in the ICS , 6192 JPY (56.92 USD ) and 9820 JPY (90.27 USD ), respectively. The ICER was calculated as 3 906 698 JPY (35 910 USD ) per QALY gained in the OCS and 6 195 781 JPY (56 952 USD ) per QALY gained in the ICS . Cost‐effectiveness of the aprepitant‐containing antiemetic therapy was limited to the OCS , considering the threshold of willingness‐to‐pay commonly accepted (5 million JPY [45 960 USD ] in Japan and 50 000 USD in the USA ). The efficacy of aprepitant offsets the costs for revisiting clinics or rehospitalization added with rescue medications in the OCS .
Type of Medium:
Online Resource
ISSN:
1347-9032
,
1349-7006
DOI:
10.1111/cas.2018.109.issue-9
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2115647-5
detail.hit.zdb_id:
2111204-6
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