Antiemetic use and chemotherapy induced nausea and vomitingrelated hospitalization costs after highly or moderately emetogenic chemotherapy

Abstract

Aim: Despite numerous available antiemetics, chemotherapyinduced nausea and vomiting (CINV) still affects many patients, and CINVrelated hospitalizations and costs often result. Materials & methods: PrecisionQ analyzed its database to evaluate CINVrelated hospitalizations and costs following antiemetics use including netupitant/fosnetupitant with palonosetron (NEPA), aprepitant/fosaprepitant with ondansetron (APON)or aprepitant/fosaprepitant with palonosetron (APPA) in patients receiving highly emetogenic chemotherapyor moderately emetogenic chemotherapy. Results: Database analysis identified 15,583 patient records (807 NEPA, 2023 APON, 12,753 APPA)and mean CINVrelated hospitalization costs were lower across all patients receiving NEPA (US$301) compared with patients receiving APON ($1006, p<0.0001) or APPA ($321, p<0.0001). Conclusion: NEPA is associated with lower CINVrelated hospitalization costs compared with APON and APPA among patients receiving highly emetogenic chemotherapy or moderately emetogenic chemotherapy.

Plain language summary

Chemotherapy patients often experience nausea and vomiting that not only has a negative impact on the patient’s quality of life but can also result in unplanned hospitalizations with high associated costs. Numerous medications and specific guidelines are available to prevent nausea and vomiting in patients with cancer. Specifically, the combination of two classes of medications (serotonin inhibitors + neurokinin type 1 inhibitors) has been shown to provide the greatest benefit. However, hospitalizations due to nausea and vomiting still occur, and providers require further information to determine the best options for their patients. In this study, the combination of netupitant/fosnetupitant with palonosetron resulted in lower hospitalization costs compared with aprepitant/fosaprepitant with ondansetron or aprepitant/fosaprepitant with palonosetron in chemotherapy patients.

Tweetable abstract

Netupitant or fosnetupitant with palonosetron result in lower chemotherapy induced nausea and vomiting related hospitalization costs compared with aprepitant or fosaprepitant-based regimens.

Keywords::

• aprepitant
• CINV
• community oncology
• cost
• hospitalization
• nausea
• netupitant
• ondansetron
• palonosetron
• vomiting

Author contributions

B Wang, H Lambert and JA Scott were responsible for the design of the analysis, data collection and interpretation, interpretation of costs and results and manuscript development. WW Nelson was responsible for study design, all data interpretation and manuscript development. WL Bailey was responsible for all data interpretation and manuscript development. V Vaidya was responsible for data analysis, interpretation and manuscript development.

Financial & competing interests disclosure

This study was funded by Helsinn Therapeutics. IC PrecisionQ was responsible for the design of the analysis, data collection and interpretation, interpretation of costs and results and manuscript development. Helsinn Therapeutics was involved in manuscript approval. WW Nelson and WL Bailey are employees of Helsinn Therapeutics. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Benjamin Holmes received funding from IC PrecisionQ and was responsible for data interpretation and manuscript development.

Ethical conduct of research

This study analyzed an existing de-identified database that does not meet the definition of human subject research as Integra PrecisionQ does not obtain information through intervention or interaction with individuals and utilizes only Health Insurance Portability and Accountability Act (HIPAA) de-identified data in accordance with the Expert Determination method (45 C.F.R. § 164.514 (b)(1)). The data used were complied with the HIPAA requirements for the privacy and security of protected health information. Institutional review board approval was not required for this study, as this study does not involve human or animal subjects or used data related to human or animal experimental investigations.