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首页> 外文期刊>journal of pharmaceutical health care and sciences >Cost-effectiveness analysis of olanzapine in four-drug antiemetic therapy in Japanese patients treated with highly emetogenic cisplatin-containing chemotherapy
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Cost-effectiveness analysis of olanzapine in four-drug antiemetic therapy in Japanese patients treated with highly emetogenic cisplatin-containing chemotherapy

机译：奥氮平在接受高致吐性顺铂化疗的日本患者四药止吐治疗中的成本效益分析

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Background Olanzapine has been shown to have an additive effect on the three-drug antiemetic therapy consisting of aprepitant, palonosetron, and dexamethasone, in a highly emetogenic cisplatin-containing chemotherapy. Although olanzapine may be more economical than aprepitant or palonosetron, an adequate cost-efficacy analysis has not been conducted. Methods We conducted a cost-utility analysis to evaluate the cost-effectiveness of olanzapine use in four-drug antiemetic therapy among Japanese patients. We simulated model patients treated with highly emetogenic cisplatin-containing chemotherapy and developed a decision-analytical model of patients receiving triple antiemetic therapy with or without olanzapine in an inpatient setting. The cost and probabilities of each treatment were calculated from the perspective of the Japanese healthcare payer. The probabilities, utility value, and other costs were obtained from published sources. One-way and probabilistic sensitivity analyses were conducted to examine the influence of each parameter on the model and the robustness of a base-case analysis. Threshold analysis was conducted to determine the cost of olanzapine that would make the incremental cost-effectiveness ratio (ICER) equivalent to the threshold ICER). The threshold incremental cost-effectiveness ratio was set at 5 million Japanese Yen (JPY) per quality-adjusted life-year (QALY) gained. Results The cost was 10,238 JPY in the olanzapine regimen and 9719 JPY in the non-olanzapine regimen. The QALY gained were 0.01065 QALYs and 0.01029 QALYs in the olanzapine and non-olanzapine regimen, respectively. The incremental cost of the olanzapine regimen relative to the non-olanzapine regimen was 519 JPY, and the incremental QALYs were 0.00036 QALY, resulting in an ICER of 1,428,675 JPY per QALY gained. In the one-way sensitivity analysis, the results were most sensitive to the utility value of incomplete control. The probabilistic sensitivity analysis revealed the probability that the ICER was below the willingness-to-pay, and the incremental QALYs was positive was 96.2. The calculated cost of olanzapine per 5 mg that would make the incremental cost-effectiveness ratio equivalent to the threshold incremental cost-effectiveness ratio was calculated to be 475 JPY. Conclusions Olanzapine was cost-effective in the four-drug antiemetic therapy for Japanese patients treated with highly emetogenic cisplatin-containing chemotherapy.
机译：背景 奥氮平已被证明对由阿瑞匹坦、帕洛诺司琼和地塞米松组成的三药止吐疗法具有累加作用，在一种高度致吐的含顺铂的化疗中。尽管奥氮平可能比阿瑞匹坦或帕洛诺司琼更经济，但尚未进行充分的成本效益分析。方法 本研究采用成本效用分析，评价奥氮平在日本患者四药止吐治疗中的成本效益。我们模拟了接受高致吐性顺铂化疗的模型患者，并开发了在住院环境中接受三联止吐治疗（联合或不联合奥氮平）的患者的决策分析模型。每种治疗的成本和概率都是从日本医疗保健支付者的角度计算的。概率、效用价值和其他成本是从公开的来源获得的。通过单因素和概率敏感性分析，检验各参数对模型的影响以及基本情况分析的稳健性。进行阈值分析以确定奥氮平的成本，使增量成本效益比（ICER）等同于阈值ICER）。阈值增量成本效益比设定为每增加一个质量调整生命年 （QALY） 500 万日元 （JPY）。结果 奥氮平方案费用为10,238日元，非奥氮平方案费用为9,719日元。在奥氮平和非奥氮平方案中，QALY获得的QALY分别为0.01065 QALY和0.01029 QALY。与非奥氮平方案相比，奥氮平方案的增量成本为519日元，增量QALY为0.00036 QALY，每增加1,428,675日元的ICER。在单因素敏感性分析中，结果对不完全控制的效用值最敏感。概率敏感性分析显示，ICER低于支付意愿，增量QALY为正的概率为96.2%。每 5 毫克奥氮平的计算成本将使增量成本效益比等于阈值增量成本效益比，计算为 475 日元。结论 奥氮平在日本高致吐性顺铂化疗患者的四药止吐治疗中具有成本效益。

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