Advances in the Management of Cytotoxic Drug-Induced Nausea and Vomiting

Freeman, Andrew; Cullen, M. H.

doi:10.1111/j.1365-2710.1991.tb00331.x

Cited by 7 publications

(2 citation statements)

References 37 publications

(22 reference statements)

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“…Ondansetron is an effective and well-tolerated anti emetic for the prevention of chemotherapy-and radio therapy-induced nausea and vomiting [1], However, healthcare expenditure is increasingly being subject to scrutiny and some constraint and therefore new drugs such as ondansetron must be justified not only clinically but also economically. Providers of healthcare therefore require full economic evaluations on which to base their decisions.…”

Section: Introductionmentioning

confidence: 99%

Ondansetron: A Cost-Effective Advance in Anti-Emetic Therapy

Cox

Hirsch²

1993

Oncology

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A cost-effectiveness analysis is one form of full economic evaluation where drug acquisition costs and the costs that are incurred as a result of using a particular treatment are assessed together with clinical efficacy. This paper reviews two such studies. One of the studies was a prospective randomised cost-effectiveness study which compared ondansetron (8 mg i.v. 0, 4 and 8 h following chemotherapy) with metoclopramide (3 mg/kg i.v. followed by an infusion of 0.5 mg/kg/h for 8 h) over the first 24 h following chemotherapy in hospitalised patients receiving highly emetogenic chemotherapy. This study showed that the cost per successfully treated patient (defined in this study as having < 1 emetic episode and no adverse events) for these 2 treatments were approximately equal: ondansetron E95 and metoclopramide E92. The second study was an economic evaluation based on data collected over a 5-day period following cyclophosphamide-based chemotherapy given on an outpatient basis for the treatment of breast cancer. Patients received an intravenous dose of 16 mg dexamethasone with either 8 mg ondansetron or 60 mg metoclopramide intravenously before chemotherapy followed by oral dosing with 8 mg ondansetron or 20 mg metoclopramide 3 times daily for 5 days. The costs per successfully treated patient (defined in this study as no vomiting or retching episodes and no anti-emetic-related adverse events during the 5-day period) were comparable: ondansetron E184 and metoclopramide E160. A recent study has established that ondansetron (8 mg) given orally twice daily is as effective as the same dose given 3 times a day. A sensitivity analysis using the cost of an ondansetron twice daily regimen showed that ondansetron is more cost-effective than metoclopramide (E133 vs. E 160). These cost effectiveness studies have shown that ondansetron is at least as cost-effective as metoclopramide and simplified ondansetron dosing schedules render ondansetron more cost-effective. These full economic evaluations illustrate that drug acquisition costs can be a misleading guide to the economic impact of antiemetics.

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Section: Introductionmentioning

confidence: 99%

Ondansetron: A Cost-Effective Advance in Anti-Emetic Therapy

Cox

Hirsch²

1993

Oncology

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“…Total-body irradiation presents a special difficulty, but open studies with ondansetron and granisetron have produced complete responses in about two thirds of patients. 82 In studies on patients taking less emetogenic (non-cisplatin containing) regimens, granisetron (40 ,ug/kg intravenously (i.v.) followed by two further doses in the first 24 h) has been shown to be more effective than a combination of chlorpromazine and dexamethasone.…”

Section: Neuropharmacologymentioning

confidence: 99%