COST-EFFECTIVENESS OF 5-HYDROXYTRYPTAMINE(3) RECEPTOR ANTAGONISTS - ARETROSPECTIVE COMPARISON OF ONDANSETRON AND GRANISETRON

As clinical and economic analyses to date have shown clear benefits of using the new 5-hydroxytryptamines receptor antagonists (5-HT(3)RAs) over traditional antiemetics, the choice between them may necessitate the assessment of comparative cost-effectiveness. This paper presents the results of an assessment of the relative cost-effectiveness of two current 5-HT(3)RAs: ondansetron and granisetron. The analysis was bas ed on a retrospective assessment of the cost and effectiveness (define d as no vomiting and no worse than mild nausea) of these new antiemeti cs. Efficacy data were based on the results of two recently published directly comparative clinical studies of ondansetron versus granisetro n in the treatment of chemotherapy-induced emesis following both singl e-dose and fractionated chemotherapy. The cost of treatment was derive d by combining clinical data from these studies with manufacturers' dr ug prices, and published costs of drug administration and emetic episo des. Costs for inpatient stay and side-effects were assumed to be equa l across both treatment alternatives, The results were expressed in te rms of the total cost per patient of emetic treatment and the cost per well-controlled patient. On this basis, granisetron was found to be m ore than 50% more cost-effective than ondansetron. This result was rob ust to variation in key assumptions concerning efficacy and cost, alth ough ondansetron would become the more cost-effective if the dose was reduced to one 8 mg i.v., with no concomitant loss of efficacy.