OBJECTIVES:

Cyclophosphamide and ifosfamide are widely used drugs for various types of childhood cancers. One of the most significant adverse reactions to these drugs is hemorrhagic cystitis (HC). Uromitexon is the most uroprotective agent that acts to neutralize the caustic metabolite, acrolein, responsible for induction of HC. The objective of the study is to evaluate the cost effectiveness of uromitexon in the prevention of urinary toxicity of cyclophosphamide and ifosfamide used in childhood cancers.

METHODS:

This is a cross-sectional study spread over a period of 6 months from January 1, to June 28, 2022, in pediatric hemato-oncology department in Rabat. It is based on the analysis of the cost effectiveness of all chemotherapy protocols containing ifosfamide, cyclophosphamide as cytotoxic drugs and uromitexon as uroprotective agent and the appearance of HC as adverse effect.

RESULTS:

Among the 562 chemotherapy protocols that were prepared in the department which are used in the treatment of 12 types of childhood cancer, 66 protocols contained ifosfamide, cyclophosphamide and uromitexon.

Ewing's sarcoma and Neuroblastoma are the most frequent types of cancer that require the administration of the above-mentioned drugs.

The Cost of ifosfamide and cyclophosphamide for Ewing's sarcoma was 13000€ versus 3500€ for uromitexon that represents 27% of total cost of chemotherapy.

In the case of Neuroblastoma, the cost of chemotherapy was 3600€ versus 2600€ for uromitexon that represents 72% of total cost of chemotherapy.

During the study only 4 cases of hemorrhagic cystitis were developed as adverse reaction.

CONCLUSIONS:

The administration of uroprotective agents is a more expensive therapeutic strategy that constitutes an additional cost which varies betweenof 27% and 72% of the total cost of chemotherapy for Ewing's sarcoma and Neuroblastoma respectively, but its use has allowed a significant decrease in the occurrence of urinary toxicity, which is very frequent especially in children treated with ifosfamide and cyclophosphamide.