Therapeutic innovation & regulatory science · 2026
Pharmacoeconomic Evaluation of Netupitant Palonosetron for Chemotherapy-Induced Nausea and Vomiting: Evidence from Economic Analyses.
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Zhang Meiyan, Zhang Fan, Tian Chen, Zhang Yunjin, Wang Chenghui, Zhang Hongnan, Zhang Lei
Аннотация
INTRODUCTION: This study was conducted to systematically evaluate the economic profile of netupitant palonosetron(NEPA) for the prevention of chemotherapy-induced nausea and vomiting(CINV)in patients receiving highly or moderately emetogenic chemotherapy (HEC/MEC). The goal is to provide evidence-based support for optimizing clinical medication decisions and standardizing future pharmacoeconomic research.
METHODS: Literature was searched through different Chinese and English databases from database inception to March 16, 2025, with study quality assessed using the CHEERS checklist. Most evaluations utilized cost-utility analysis via Markov or decision tree models, primarily focusing on direct medical costs from healthcare payer or system perspectives.
RESULTS: Nine studies meeting the inclusion criteria were analyzed. The results confirm the economic advantages of NEPA for CINV prophylaxis. In Western healthcare systems (UK, Spain, Italy, and the US), NEPA was frequently identified as a dominant strategy, providing greater health benefits (QALYs) at lower total costs. In China, NEPA was shown to be cost-effective at a willingness-to-pay (WTP) threshold equivalent to one times the national GDP per capita. Sensitivity analyses revealed that the cost-effectiveness of NEPA is highly sensitive to local drug pricing and variations in clinical practice.
CONCLUSION: NEPA is a cost-effective or even dominant strategy for CINV prophylaxis in both HEC and MEC populations. These findings provide a scientific basis for drug reimbursement negotiations and clinical pathway optimization. Future research should utilize real-world evidence across multiple chemotherapy cycles to further validate its long-term economic value and support value-based healthcare decisions.
METHODS: Literature was searched through different Chinese and English databases from database inception to March 16, 2025, with study quality assessed using the CHEERS checklist. Most evaluations utilized cost-utility analysis via Markov or decision tree models, primarily focusing on direct medical costs from healthcare payer or system perspectives.
RESULTS: Nine studies meeting the inclusion criteria were analyzed. The results confirm the economic advantages of NEPA for CINV prophylaxis. In Western healthcare systems (UK, Spain, Italy, and the US), NEPA was frequently identified as a dominant strategy, providing greater health benefits (QALYs) at lower total costs. In China, NEPA was shown to be cost-effective at a willingness-to-pay (WTP) threshold equivalent to one times the national GDP per capita. Sensitivity analyses revealed that the cost-effectiveness of NEPA is highly sensitive to local drug pricing and variations in clinical practice.
CONCLUSION: NEPA is a cost-effective or even dominant strategy for CINV prophylaxis in both HEC and MEC populations. These findings provide a scientific basis for drug reimbursement negotiations and clinical pathway optimization. Future research should utilize real-world evidence across multiple chemotherapy cycles to further validate its long-term economic value and support value-based healthcare decisions.