American journal of hospital pharmacy
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Meta Analysis Comparative Study
Pharmacoeconomic analysis of ondansetron versus metoclopramide for cisplatin-induced nausea and vomiting.
A pharmacoeconomic analysis of ondansetron versus metoclopramide use in patients receiving high-dose cisplatin therapy is reported. A meta-analysis of the literature was performed to synthesize the results of clinical trials of ondansetron and metoclopramide for the prevention of nausea and vomiting in patients receiving high-dose cisplatin therapy. A cost-benefit analysis was performed by constructing a decision tree of the possible outcomes of treatment with ondansetron or metoclopramide. ⋯ The cost-utility analysis yielded an incremental cost of ondansetron of $168,391 ($407,667) per QALY in 40-kg (70-kg) patients. Sensitivity analysis showed robustness of the expected outcomes except in a best-case scenario. A cost-utility analysis suggested that, compared with metoclopramide, ondansetron provides a small antiemetic benefit at a large additional cost.