ArticleInternational journal of clinical oncology2026
Clinical benefit and economic value of fosnetupitant versus aprepitant in carboplatin-Based chemotherapy: a real-world study.
Article in International journal of clinical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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11 authors.
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Abstract
backgroundFosnetupitant (F-NTP) has demonstrated superior antiemetic efficacy compared with aprepitant in carboplatin-based chemotherapy in real-world settings. However, whether this clinical benefit translates into economic value remains unclear. We evaluated the cost-effectiveness of F-NTP compared with aprepitant and examined the impact of incorporating productivity loss from a societal perspective.
methodsA real-world three-phase decision-analytic model with a 7-day time horizon was constructed to estimate quality-adjusted life years (QALYs) based on chemotherapy-induced nausea and vomiting health states. Economic outcomes were assessed from a payer perspective using a willingness-to-pay (WTP) threshold of 5 million JPY per QALY, followed by a societal scenario that included productivity loss. Deterministic and probabilistic sensitivity analyses were performed to evaluate the parameter uncertainty.
resultsFrom the payer perspective, F-NTP provided greater QALY gains than aprepitant but at a higher cost, resulting in an incremental cost-effectiveness ratio (ICER) of JPY 13,374,496/QALY, which exceeded the prespecified WTP threshold of JPY 5 million/QALY. The inclusion of productivity loss reduced the ICER to JPY 12,413,622/QALY and modestly increased the probability of F-NTP being cost-effective. However, aprepitant remained the preferred strategy at the prespecified WTP threshold.
conclusionAt the prespecified WTP threshold of 5 million JPY/QALY, aprepitant was more likely to be cost-effective than F-NTP for carboplatin-based chemotherapy. Incorporating productivity loss reduced the ICER for F-NTP and modestly increased its probability of being cost-effective, although the overall conclusion regarding cost-effectiveness remained unchanged.
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