Health outcomes and cost-effectiveness of aprepitant in outpatients receiving antiemetic prophylaxis for highly emetogenic chemotherapy in Germany

Eur J Cancer. 2007 Jan;43(2):299-307. doi: 10.1016/j.ejca.2006.09.019. Epub 2006 Nov 28.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: Aprepitant substantially improved CINV-related health outcomes in patients undergoing highly emetogenic chemotherapy. Incremental benefits materialised in a cost-effective fashion.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antiemetics / economics
  • Antiemetics / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Aprepitant
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects
  • Clinical Trials, Phase III as Topic
  • Cost-Benefit Analysis
  • Dexamethasone / administration & dosage
  • Dexamethasone / adverse effects
  • Double-Blind Method
  • Drug Therapy, Combination
  • Health Resources / economics
  • Health Resources / statistics & numerical data
  • Humans
  • Morpholines / economics
  • Morpholines / therapeutic use*
  • Multicenter Studies as Topic
  • Nausea / chemically induced
  • Nausea / economics
  • Nausea / prevention & control
  • Neoplasms / drug therapy*
  • Neoplasms / economics
  • Ondansetron / economics
  • Ondansetron / therapeutic use*
  • Randomized Controlled Trials as Topic
  • Treatment Outcome
  • Vomiting / chemically induced
  • Vomiting / economics
  • Vomiting / prevention & control

Substances

  • Antiemetics
  • Morpholines
  • Aprepitant
  • Ondansetron
  • Dexamethasone
  • Cisplatin