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Meta Analysis Comparative Study
Health outcomes and cost-effectiveness of aprepitant in outpatients receiving antiemetic prophylaxis for highly emetogenic chemotherapy in Germany.
- Florian Lordick, Birgit Ehlken, Angela Ihbe-Heffinger, Karin Berger, Karl J Krobot, James Pellissier, Glenn Davies, and Robert Deuson.
- Third Medical Department, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 München, Germany. f.lordick@lrz.tu-muenchen.de
- Eur. J. Cancer. 2007 Jan 1;43(2):299-307.
BackgroundChemotherapy-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.MethodsA 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.ResultsComplete 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.ConclusionsAprepitant substantially improved CINV-related health outcomes in patients undergoing highly emetogenic chemotherapy. Incremental benefits materialised in a cost-effective fashion.
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