Economic Evaluation of a New Antiemetic Drug ??? Palonosetron versus Ondansetron

Publisher Website
Google Scholar
Abstract
Objectives: This study aimed to identify, measure and evaluate expected costs of innovative palonosetron-based antiemetic therapy versus ondansetron-based treatment, the ultimate aim being to measure the drug price ratio (DPR) of the two pharmacological treatments in five different European countries. Methods: A decision model compared two antiemetic treatments — palonosetron and ondansetron — in terms of expected costs of emesis management from a hospital perspective. The model was compiled for 374 patients. The clinical superiority of palonosetron in preventing acute and delayed emesis, measured in terms of: (i) complete response rates, (ii) number of emetic episodes, and (iii) administration of rescue medication, was derived from a previously published clinical trial. The cost data were gathered through economic questionnaires distributed in 11 European hospital centres. The expected costs of emesis management with palonosetron and ondansetron at ondansetron prices were used to calculate the DPR for palonosetron in each of the five European countries. Results: In the baseline analysis, DPR varied from 1.55 (in Russia) to 2.60 (in the UK). The sensitivity analysis of the unit costs of emetic episodes and rescue medication identified a range from 1.39 (in Germany) to 4.09 (in Russia). Even in the least favourable clinical scenario, palonosetron was a preferred antiemetic strategy with a DPR >1 in all five countries. Conclusions: This is the first economic evaluation analysis of palonosetron. The results demonstrate that palonosetron, because of its superior clinical efficacy in controlling emesis, could have a favourable DPR when compared with ondansetron in all five countries considered and still offer lower or equal net treatment costs for the hospital.