[Cost-effectiveness analysis of 5-HT3 receptor antagonist drugs in cancer chemotherapy]

Recently, ambulatory treatment centers (ATC) are markedly increasingboth in number and scale. It is therefore important to consolidate an efficient therapeutic system. A decrease in both treatment time and waitingtime leads to not only the improvement of the quality of life (QOL) for patients but also the efficient use of personnel and running costs for medical institutions by reducingthe bed occupation rate. In ATC, 5-HT3 receptor antagonists are extensively used for high emetic risk patients. However, their high cost and prolonged treatment causes one of the problems in improvingthe efficiency of the therapeutic system when they are administered by intravenous infusion. Amongthe 4 types of 5-HT3 receptor antagonists (injections) currently available in Japan, azasetron is the only drugthat is not designated as a powerful drug and that can be administered by bolus intravenous infusion. In this study, we investigated azasetron and granisetron from the standpoint of pharmacoeconomics with a simulation model using the results of clinical studies in Japan. Accordingto the results of cost-effectiveness analysis, therapeutic and time costs per patient for azasetron 10 mgand granisetron 2 mg (calculated in consideration of both medical institutions and patients) was 8,219 and 10,193 yen, respectively. This gap was attributable to the time loss due to the difference in administration methods. The result suggests that this time loss is more significant not only for patients but also for medical staff than the loss attributable to the drugcost. Furthermore, the bolus intravenous infusion of azasetron is considered superior to the non-bolus intravenous infusion of granisetron from a pharmacoeconomic standpoint. It is desirable to choose the appropriate administration method of 5-HT3 receptor antagonists in various chemotherapy regimens for the purpose of reducingthe treatment time and promotingthe efficiency of the therapeutic system at ATCs.