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Granisetron more economical than palonosetron, ondansetron for preventing chemo-induced vomiting

04 Oct 2017

Granisetron, in combination with dexamethasone, appears to be a more cost-effective treatment option than palonosetron and ondansetron for the prevention of nausea and vomiting following highly emetogenic chemotherapy, according to a study from China.

Researchers developed a Markov decision-analytic model to determine, from the perspective of the Chinese healthcare system, which of the following strategies was the most cost-effective option in patients following highly emetogenic chemotherapy: 0.25 mg palonosetron (0.25P), 16 mg ondansetron (Onda) or 3 mg granisetron (Gran).

They investigated the health and economic outcomes of the three frequently used strategies using clinical and utility data obtained from published studies. Current local Chinese practices were used to calculate the cost data, and sensitivity analyses were performed to determine the impact of uncertainty regarding the results.

Base-case analysis revealed that the 0.25P strategy delivered maximum health benefits compared with the other two strategies, but the probabilistic sensitivity analysis showed that the Gran strategy was the most cost-effective approach when the willingness-to-pay threshold was not more than $22,515 per quality-adjusted life year.

In addition, it is not cost-effective to use palonosetron in preventing overall nausea and vomiting following highly emetogenic chemotherapy in Chinese patients, according to researchers.

These findings partially support that of the study by Matsumaru and colleagues, who concluded that palonosetron was superior to granisetron in preventing nausea and vomiting induced by chemotherapy for haematological cancers. In Japan, the standard dose of palonosetron is 0.75 mg. The researchers recommended the comparison of a dose of 0.25P with 0.75 mg in future studies. [Mol Clin Oncol 2017;7:629-632]

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