6 VIEW

Ondametron prophylaxis - costs outweigh benefits

Ondansetron prophylaxis provides a modest antiemetic benefit at a large additional cost, compared with metoclopramide, in patients with cancer undergoing high-dose cisplatin therapy, according to a US study.

Findings from the meta-analysis revealed no significant difference between existing clinical trials in the efficacy of ondansetron or metoclopramide. However, cost-benefit analysis identified fewer emetic episodes among ondansetron, compared with metoclopramide, recipients - 2.03 vs 2.69 episodes, respectively. Also, the mean complete-response rate was 44% and 30% for the ondansetron and metoclopramide groups, respectively.

In terms of cost, ondansetron therapy costs $US 139.38 for a 40kg patient and $211 for a 70kg patient, report the investigators. In contrast, metoclopramide therapy costs $116.35 and $154.56, respectively. Notably, the incremental increase in quality-adjusted life-years (QALYs) for ondansetron­treated patients was estimated at 0.00014 QALYs. Thus, the incremental cost of ondansetron/QALY was calculated at $168 391 and $407 667 for a 40kg and 70kg patient, respectively. Slight to moderate reductions in ondansetron dosage were required in order to achieve a costlQALY ratio of $100000, the investigators point out. * * All itlJervenJiUfl costing $50 {X)()...$}OO LUYQALY demonstrales

'marginal evidence' for adoption as defined by Canadkuz guidelines

Zbrozck AS. Cantor S8. Cardenas MP. Hill DP. Pharmacoeconomic analysis of ondan.setron versus metoclopramidc for cisplatin-induccd nausea and vomiting.

American Journal of Hospital Pharmacy 51: 1555-1563. 15 Jun 1994 """,.,,,,

23 Jul 1994 INPHARMAe

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0156.2703194/0947-00061$01.000 Adla International Limited 1994. All rlghta r_rved