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Cost-effectiveness of prophylactic ramosetron in the prevention of postoperative nausea and vomiting

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  • David Suh
  • Dong-Won Kim
  • Seung-Mi Lee
  • Yu-Seon Jung
  • Sun-Young Jung
  • Chul-Min Kim

Abstract

Objectives: This study was conducted to assess the cost-effectiveness of prophylactic use of ramosetron compared to no antiemetic medications for the prevention of postoperative nausea and vomiting (PONV) from the healthcare payer and societal perspectives in South Korea. Method: A decision analytic model was constructed to assess the cost-effectiveness of prophylactic ramosetron use versus no antiemetic therapy at 24-hour and 48-hour periods post-surgery over a 5-day duration. The model was populated using costs and utility parameters from published studies as well as from surveys of an expert panel of physicians using structured questionnaires. The cost parameters included the costs of drugs, treatment, patient time, productivity loss, and transportation. Effectiveness was measured using quality adjusted life years (QALYs). The study outcome was the incremental cost-effectiveness ratio (ICER). The parameter uncertainties were addressed using deterministic and probabilistic scenario analyses. Results: The base-case analysis showed that, on average, patients treated with prophylactic ramosetron had lower costs from both the healthcare payer (US$16.88 vs US$17.33) and societal (US$16.89 vs US$18.72) perspectives and higher QALYs (0.0121 vs 0.0114) over the 5-day study duration compared to patients without any antiemetic medications. Deterministic and probabilistic sensitivity analyses were conducted to examine the robustness of results for the parameters included in the model. The acceptability curve probability showed that treating patients with ramosetron compared to no antiemetic medications was more than 99% cost-effective at a willingness-to pay threshold of US$5,000/QALY from both payer and societal perspectives. Conclusion: The results demonstrated that prophylactic use of ramosetron compared to no antiemetic therapy is highly cost-effective to prevent PONV for patients undergoing surgery from both healthcare payer and societal perspectives. The cost effectiveness is the result of the decrease in the incidence of PONV and the direct treatment costs of severe PONV with improved patient quality of life.

Suggested Citation

  • David Suh & Dong-Won Kim & Seung-Mi Lee & Yu-Seon Jung & Sun-Young Jung & Chul-Min Kim, 2024. "Cost-effectiveness of prophylactic ramosetron in the prevention of postoperative nausea and vomiting," PLOS ONE, Public Library of Science, vol. 19(10), pages 1-14, October.
    • Handle: RePEc:plo:pone00:0309592
    DOI: 10.1371/journal.pone.0309592
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    References listed on IDEAS

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    1. EunJin Ahn & GeunJoo Choi & Hyun Kang & ChongWha Baek & YongHun Jung & YoungCheol Woo & SangSeok Lee & YeoGoo Chang, 2016. "Palonosetron and Ramosetron Compared for Effectiveness in Preventing Postoperative Nausea and Vomiting: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 11(12), pages 1-15, December.
    2. Ayako Yokoi & Takahiro Mihara & Koui Ka & Takahisa Goto, 2017. "Comparative efficacy of ramosetron and ondansetron in preventing postoperative nausea and vomiting: An updated systematic review and meta-analysis with trial sequential analysis," PLOS ONE, Public Library of Science, vol. 12(10), pages 1-25, October.
    3. Briggs, Andrew & Sculpher, Mark & Claxton, Karl, 2006. "Decision Modelling for Health Economic Evaluation," OUP Catalogue, Oxford University Press, number 9780198526629, Decembrie.
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