Table 4.
Summary of expected health outcomes and costs over 5 days after cycle 1 of chemotherapy23
| Aprepitant regimen (n = 212) | UK comparator regimena (n = 216) | Absolute differenceb (relative difference) | |
|---|---|---|---|
| Health outcome measure | |||
| Mean number emetic eventsc | 2.11 | 2.61 | −0.49 (−18.9%) |
| Complete responsed | 63.7% | 46.8% | 16.9% (36.2%) |
| Emesis-free over 5-day cycle | 69.8% | 52.8% | 17.0% (32.3%) |
| Mean number emesis-free daysc | 4.3 | 3.9 | 0.4 (9.5%) |
| CINV-free over 5-day cycle | 60.8% | 42.6% | 18.3% (42.9%) |
| Mean number CINV-free daysc | 3.9 | 3.4 | 0.5 (13.7%) |
| No impact on daily life due to nausea and vomiting | 69.8% | 56.5% | 13.3% (23.5%) |
| Quality-adjusted life days | 3.10 | 2.75 | 0.35 (12.6%) |
| Healthcare resource measure | |||
| Antiemetic regimen | |||
| Aprepitant | £47.43 | – | £47.43 |
| Ondansetron | £10.18 | £5.09 | £5.09 |
| Dexamethasone | £0.86 | £5.29 | −£4.44 |
| Metaclopramide | – | £0.42 | −£0.42 |
| Subtotal | £58.47 | £10.80 | £47.67 |
| Health-care resource | |||
| Outpatient cared | £6.71 | £7.22 | −£0.51 |
| Hospitalization | – | £36.32 | −£36.32 |
| Rescue medication | £0.57 | £1.09 | −£0.52 |
| Subtotal | £7.28 | £44.63 | −£37.35 |
| Total costs | £65.75 | £55.43 | £10.32 |
| Summary measures | |||
| Total aprepitant costs offset by HCR savings with use of aprepitant | £37.11 | ||
| Additional drug cost per emesis-free day gained with use of aprepitant | £28 | ||
| Additional drug cost per CINV-free day gained with use of aprepitant | £22 | ||
| Additional drug cost per emetic event avoided with use of aprepitant | £97 | ||
| Incremental cost-effectiveness ratio (ICER), £/QALY | £10,847 | ||
Notes:
The data shown here are from breast cancer patients who received the clinical trial control regimen in the reference clinical trial.23 For the purpose of this analysis, we have used this data as the best estimate of the efficacy of the UK comparator regimen, given the lack of efficacy data for the UK comparator regimen in comparison with an aprepitant regimen;
difference represents aprepitant regimen value minus comparator regimen value;
mean number over 5 days;
complete response includes patients with complete response at best or complete protection;
outpatient care includes visits to primary care physicians or medical specialists, visits for laboratory tests not mandated by the study protocol, home health care, and emergency room visits.
Abbreviations: CINV, chemotherapy-induced nausea and vomiting; £, pound sterling; HCR, health care resource; QALY, quality-adjusted life year; UK, United Kingdom.