Impact of ondansetron and granisetron on chemotherapy-induced emesis in adults: the need for comparative pharmacoeconomic data.

Abstract The introduction of the 5-hydroxytryptamine 3 (5-HT3) antagonists has made a significant contribution to the control of chemotherapy-induced nausea and vomiting and to improving patient quality of life. The clinical impact of two of these compounds, ondansetron and granisetron, was reviewed. It was concluded that, given the existing body of data on ondansetron and granisetron, it is difficult to determine whether any major differences can be identified between these two drugs, but that in most instances both are significantly superior to conventional antiemetics. To ensure efficient use of scarce health care resources, a decision to select one or the other should be based on economic (cost-effectiveness) data from appropriately designed randomized trials that include all aspects of antiemetic therapy (including iatrogenic complications) and that also consider relevant alternatives (eg, a conventional regimen vs two or more regimens based on 5-HT3 antagonists). Prospective studies designed to generate comparative clinical and economic data are needed in which outcomes are assessed by a common scale and in which previously established optimal doses and dosing schedules of each compound (either alone or in combination therapy) are used.