Background: Aprepitant has been shown to reduce chemotherapy-induced nausea and vomiting in children receiving highly emetogenic chemotherapy (HEC). In this study, we assessed the cost-effectiveness of aprepitant for children receiving HEC in India, United Kingdom, and the United States. Procedure:We utilized individual patient-level outcome data from a pediatric randomized trial, which demonstrated the superiority of an aprepitant-based anti-emetic prophylaxis over standard ondansetron and dexamethasone for HEC. Health state for each day of follow-up was analyzed and quality-adjusted life years (QALYs) were estimated. The incremental cost-utility ratio (ICUR), incremental cost-effectiveness ratio (ICER), and net monetary benefit (NMB) for each country were estimated. Sensitivity analyses by varying cost of aprepitant, hospitalization, and health state utility values by ±25% were conducted.Results: Use of the aprepitant-based regimen resulted in gain of 0.

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Chemotherapy-induced nausea and vomiting (CINV) are so significant and prevalent that the discovery of antiemetics was recently voted, by both physicians and patients alike, as one of the "Top 5 Advances in 50 Years of Modern Oncology." 1 We recently published the results of a phase-III study which explored whether the addition of olanzapine to standard pediatric antiemetic regimens would improve their efficacy. 2