Cost-utility and budget impact analyses of the use of NEPA for chemotherapy-induced nausea and vomiting prophylaxis in Italy.
BMJ Open
; 7(7): e015645, 2017 Aug 01.
Article
em En
| MEDLINE
| ID: mdl-28765126
ABSTRACT
OBJECTIVE:
To evaluate the efficiency of resources allocation and sustainability of the use of netupitant+palonosetron (NEPA) for chemotherapy-induced nausea and vomiting (CINV) prophylaxis assuming the Italian National Health Service (NHS) perspective. A published Markov model was adapted to assess the incremental cost-utility ratio of NEPA compared with aprepitant (APR) + palonosetron (PALO), fosaprepitant (fAPR) + PALO, APR + ondansetron (ONDA), fAPR + ONDA in patients receiving a highly emetogenic chemotherapy (HEC) and with APR + PALO and fAPR + PALO in patients receiving a moderately emetogenic chemotherapy (MEC).SETTING:
Oncology hospital department in Italy.METHODS:
A Markov model was used to determine the impact of NEPA on the budget of the Italian NHS on a 5-day time horizon, corresponding to the acute and delayed CINV prophylaxis phases. Direct medical costs considered were related to antiemetic drugs, adverse events management, CINV episodes management. Clinical and quality of life data referred to previously published works. The budget impact analysis considered the aforementioned therapies plus PALO alone (for HEC and MEC) on a 5-year time horizon, comparing two scenarios one considering the use of NEPA and one not considering its use. PRIMARY AND SECONDARY OUTCOMEMEASURES:
Incremental cost per quality adjusted life year (QALY) and differential economic impact for the Italian NHS between the two scenarios considered.RESULTS:
NEPA is more effective and less expensive (dominant) compared with APR + PALO (for HEC and MEC), fAPR + PALO (for HEC and MEC), APR + ONDA (for HEC), fAPR + ONDA (for HEC). The use of NEPA would lead to a 5-year cost decrease of 63.7 million (42.7 million for HEC and 20.9 million for MEC).CONCLUSIONS:
NEPA allows an efficient allocation of resources for the Italian NHS and it is sustainable, leading to a cost decrease compared with a scenario which does not consider its use.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Piridinas
/
Quinuclidinas
/
Vômito
/
Análise Custo-Benefício
/
Isoquinolinas
/
Antieméticos
/
Náusea
/
Antineoplásicos
Tipo de estudo:
Health_economic_evaluation
Aspecto:
Patient_preference
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
BMJ Open
Ano de publicação:
2017
Tipo de documento:
Article