Costs of treating and preventing nausea and vomiting in patients receivingchemotherapy

Purpose: To evaluate the effect of ondansetron availability on the costs of managing nausea and vomiting, Methods: We retrospectively assessed antiemetic costs (drug costs, nursing time, pharmacy time, physician's time, supplies, and facility "hotel" costs , in 1991 Canadian dollars) for all patients who received moderately or hig hly emetogenic chemotherapy from 6 months before to 6 months after ondanset ron became commercially available in September 1991, We compared the costs for treating patients who received ondansetron versus those who received ot her antiemetic regimens, the costs for treating patients in the 6 months be fore versus the 6 months after ondansetron commercial availability, and the costs for treating patients in the first 4 months versus the last 4 months of the study period. Results: We found no cost differences for patients treated with ondansetron versus of her antiemetic regimens. However, there was a significant reduct ion in emesis management costs For patients treated after versus before the availability of ondansetron: for patients treated in the last third versus first third of the study period, there was a decrease in cost per patient per month of: treatment of $374 (95% confidence interval, $243 to $505), Th ese savings were achieved through a reduction in hospital bed days and othe r costs associated with the prevention and more effective management of nau sea and vomiting. At the same time, the number of patients who received eme togenic chemotherapy and their average age increased, presumably because of the better control of gastrointestinal toxicity. Conclusion: Ondansetron availability has been associated with changes in th e clinical management of cancer patients receiving chemotherapy and with ov erall cost savings compared with previously available antiemetic therapy. J Clin Oncol 71:344-351. (C) 1999 by American Society of Clinical Oncology.