[Cost-effectiveness analysis of aripiprazole once-monthly versus paliperidone palmitate once-monthly in the treatment of schizophrenia in France]. / Analyse coût-efficacité de l'aripiprazole injectable à libération prolongée (AILP) comparé au palmitate de palipéridone (PP) dans le traitement de la schizophrénie en France.

OBJECTIVE: The aim of the study was to estimate the cost-effectiveness ratio of aripiprazole once-monthly compared to once-monthly injectable paliperidone palmitate in the treatment of schizophrenia in France on the basis of results and data from the QUALIFY study. METHODS: Consumed resources data measured with a dedicated questionnaire and results on the quality of life scales from the QUALIFY study were combined with French standard unit costs of each collected consumed resources during QUALIFY to estimate the cost-effectiveness ratios of the two products. Multivariate sensitivity analyses were performed to test the combined impact of the different assumptions. RESULTS: Findings of the study showed greater efficacy on the quality of life (QLS) and psychiatric evaluation scales (CGI-S and CGI-I) observed in QUALIFY of aripiprazole compared with paliperidone palmitate. Findings also suggest a trend (P=0.0733) in the reduction of total costs linked to a statistical decrease (P<0,0001) in drug costs in the aripiprazole group. These findings are reinforced by the probabilistic sensitivity analyses. CONCLUSION: Aripiprazole appeared to be more cost-effective than paliperidone palmitate in the French context. Limits of this study are mainly related with the duration of the clinical trial and to assumptions on the transposability of measured consumed resources in the international clinical trial to the French healthcare system.

[Individualized pharmaceutical consultations in the management of chemotherapy-induced nausea and vomiting]. / Place des consultations pharmaceutiques individualisées dans la prise en charge des nausées et vomissements chimio-induits.

In order to prevent and control the chemotherapy-induced nausea and vomiting (CINV), the military hospital Percy (Clamart, France) developed a systematic "CINV consultation". With 1.500 consultations conducted in 2013, the aim of this study was to confront professional practices and the patient's point of view to assess the efficiency of this procedure and consider a restructuring to optimize it. A preliminary study was conducted: 30 medical records of patients who had chemotherapy cure during 2013 have been analysed and 30 patients have completed an evaluation questionnaire anonymously. Patients were very satisfied (63%) or satisfied (37%) of these consultations. Most of them (71%) said the consultations were useful before every cure, while 27% thought that the consultation at first cure or when the chemotherapy protocol changed was enough. CINV consultations were estimated as complementary of the medical consultation for 93% of the patients. Most of the patients (70%) never had CINV or just at the first cure. Furthermore, the anti-emetic treatment was adapted to the new chemotherapy emetic level in only 53% of protocol changes. Patients have expressed a real interest in these CINV consultations and the benefits they could get from them. Moreover, patients' side effects are stabilized faster thanks to those pharmaceutical interviews. In fact, it seems that these consultations are mostly needed for the first cure (until patient stabilization) and when there is a chemotherapy protocol change.