Cost-effectiveness analysis of olanzapine-containing antiemetic therapy for managing highly emetogenic chemotherapy in Southeast Asia: a multinational study

Abstract

The use of olanzapine as part of standard antiemetic regimen is cost-effective for the prevention of CINV in patients receiving HEC in multiple SEA countries.

Cost-utility analysis of olanzapine in four-drug antiemetic therapy in Japanese patients treated with highly emetogenic cisplatin-containing chemotherapy

“…Chanthawong et al reported that compared to the doublet antiemetic regimen (dexamethasone plus rstgeneration 5-HT 3 receptor antagonist), the addition of olanzapine resulted in incremental QALY of 0.0022-0.0026, with cost savings of 2.98 USD, 27.71 USD, and 52.20 USD in Thailand, Malaysia, and Indonesia, respectively [15]. At the same time, they reported that in Singapore, switching from aprepitant to olanzapine in a triplet antiemetic regimen (dexamethasone, rst-generation 5-HT 3 receptor antagonist, and aprepitant) resulted in cost savings of 60.91 USD and incremental QALYs of 0.0005 [15]. In Japan, there have been several reports examining the cost-effectiveness of aprepitant and palonosetron [12][13][14].…”

“…CR was subdivided into two mutually exclusive health outcomes: complete protection (CP), which was de ned as no emesis, rescue antiemetic therapy, and signi cant nausea, and complete response at best (CRB), which included those who achieved CR but not CP. The analysis period lasted for ve days, as in previous reports [12][13][14][15][16].…”

“…According to previous reports, we simulated model patients treated with highly emetogenic cisplatincontaining chemotherapy and developed a decision-analytic model (Fig. 1) [12][13][14][15][16]. Based on a phase III clinical trial conducted in Japan (J-FORCE study) [7], the model patients received either a four-drug or a three-drug regimen.…”

“…A utility value for each health state was assigned to previous reports. Utility values of 0.9 for CP, 0.7 for CRB, and 0.2 for IR were used (Table 1) [12,13,15,17]. If drowsiness occurred, the utility value was assumed to decrease by 0.1 [18].…”

“…The rapid aging of Japan's population and the resulting increase in medical costs have become a severe problem. Because NK 1 receptor antagonists, such as aprepitant and 5-HT 3 receptor antagonists, are more expensive than classical antiemetics, several studies have examined their costeffectiveness in Japan and overseas [12][13][14][15][16]. In Japan, aprepitant use was reportedly cost-effective for outpatient treatment but not cost-effective under inpatient conditions [12].…”