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首页> 外文期刊>BMC Health Services Research >Cost-utility analysis of palonosetron in the antiemetic regimen for cisplatin-containing highly emetogenic chemotherapy in Japan
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Cost-utility analysis of palonosetron in the antiemetic regimen for cisplatin-containing highly emetogenic chemotherapy in Japan

机译：日本顺铂高均匀化疗止吐抑制方案对止吐方案的成本实用性分析

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An antiemetic triplet regimen of 5-hydrotryptamine-3 receptor antagonist, dexamethasone, and aprepitant is the standard prophylaxis with highly emetogenic chemotherapy (HEC). A randomized phase III trial comparing palonosetron (PALO) versus granisetron (GRA) in the triplet antiemetic regimen (The TRIPLE study) showed the superiority of PALO over GRA for delayed-phase vomiting in patients receiving cisplatin-based HEC. However, economic efficiency evaluations including quality of life have not been done. The present study was a cost-utility analysis of PALO within the Japanese medical insurance system. The data source was the results of the TRIPLE study. A decision tree was constructed to assess the incremental cost-effectiveness ratio (ICER) using quality-adjusted life years (QALYs) and the medical service fees and the drug price for 2018 from the perspective of the payer. A one-way sensitivity analysis and a probabilistic sensitivity analysis (PSA) were performed to assess the robustness of the model. A threshold analysis was performed to determine the cost-effective price of PALO. In the base case, the estimated incremental effect of PALO addition was 0.000645 QALYs, the estimated incremental cost was 10,455 JPY (93.21 USD), and the ICER was 16,204,591 JPY QALY (144,465 USD/QALY). In the PSA, the probability of superior cost-effectiveness was 3.64%. In the threshold analysis, the acceptable price of PALO was estimated to be 7,743 JPY (69.03 USD). If willingness-to-pay is taken as 5,000,000 JPY/QALY (44,575 USD/QALY), the antiemetic regimen using PALO for cisplatin-containing HEC was not cost-effective at this time. The cost of drugs, with the arrival of inexpensive generic drugs, will make a major contribution to its cost-effectiveness.
机译：5-加氢妥胺-3受体拮抗剂，地塞米松和共用的止吐三重药方案是具有高氧化化疗（HEC）的标准预防。将Palonosetron（Palo）与Granisetron（Gra）进行三联抗助剂方案（三重研究）的随机阶段III试验（三重研究）显示Palo在接受顺铂的HEC患者延迟相呕吐的GRA的优越性。但是，没有完成包括生活质量的经济效率评估。本研究是日本医疗保险制度帕洛的成本实用性分析。数据源是三重研究的结果。建立了决策树以评估使用质量调整后的寿命（QALYS）和2018年医疗服务费用的增量成本效益（QALYS）以及2018年的药物价格从付款人的角度来看。进行单向敏感性分析和概率敏感性分析（PSA）以评估模型的稳健性。进行阈值分析以确定帕洛的成本效益。在基本情况下，Palo添加的估计增量效应为0.000645QALYS，估计的增量成本为10,455日元（93.21美元），而铁币为16,204,591日元QALY（144,465美元/ QALY）。在PSA中，卓越成本效益的可能性为3.64％。在门槛分析中，帕洛的可接受价格估计为7,743日元（69.03美元）。如果愿意付费为5,000,000日元/ QALY（44,575美元/ QALY），则目前使用含Cisplatin的HEC的助剂方案并不具有成本效益。随着廉价的仿制药的到来，药物的成本将为其成本效益作出重大贡献。

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