Pharmacoeconomic Evaluation of an Olanzapine-Containing Quadruple Antiemetic Regimen for the Prevention of CINV: An Efficacy-Cost Analysis
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Keywords
chemotherapy-induced nausea and vomiting, olanzapine, antiemetic regimen, cost-effectiveness analysis, pharmacoeconomics
Abstract
This study systematically evaluates the efficacy, safety, and cost-effectiveness of an olanzapine-containing quadruple antiemetic regimen compared with the standard triple regimen for preventing chemotherapy-induced nausea and vomiting (CINV) associated with moderately to highly emetogenic chemotherapy. The aim is to provide evidence-based guidance for optimizing clinical CINV management. The quadruple regimen significantly improved the complete response rate for delayed-phase CINV to 83%–86% and increased the overall no-nausea rate to 78.7%, demonstrating superior efficacy compared with the standard triple regimen. Adding olanzapine addressed the pharmacological limitations of the standard regimen by enhancing delayed-phase coverage and controlling refractory nausea through multi-receptor antagonism. Pharmacoeconomic analysis indicates that, despite the additional cost of olanzapine, the quadruple regimen reduces the need for rescue medications and complication management costs due to its enhanced efficacy, yielding cost savings of 300–500 yuan (RMB) per treatment cycle and a superior cost-effectiveness ratio. Incorporating low-dose olanzapine into the standard triple regimen offers a more effective and cost-efficient approach to preventing CINV in patients receiving moderately to highly emetogenic chemotherapy. Future research should focus on developing individualized predictive models and validating real-world effectiveness in diverse patient populations.
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