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

Figures & data

Table 1. Study cohorts and baseline demographics.

	NEPA (n=807)	APON (n=2023)	APPA (n=12753)	p-value^†
Age, mean (SD)	69.88 (8.52)	69.49 (8.46)	70.39 (8.10)	<0.0001
Sex, n (%)				0.0662
Female	442 (54.8)	1079 (53.3)	6937 (54.4)
Male	365 (45.2)	925 (45.7)	5737 (45.0)
Unknown	0	19 (0.9)	79 (0.6)
Race, n (%)				<0.0001
Asian	5 (0.6)	32 (1.6)	83 (0.7)
Black or African–American	69 (8.6)	105 (5.2)	582 (4.6)
White	353 (43.7)	998 (49.3)	7242 (56.8)
Other	380 (47.1)	888 (43.9)	4846 (38.0)
Chemotherapy type, n (%)				<0.0001
HEC	583 (72.2)	1283 (63.4)	8556 (67.1)
MEC	224 (27.8)	740 (36.6)	4197 (32.9)
Tumor type, n (%)				<0.0001
Liquid	61 (7.6)	201 (9.9)	936 (7.3)
Solid	428 (53.0)	1511 (74.7)	9662 (75.8)
Other	17 (2.1)	258 (12.8)	568 (4.5)
Missing	301 (37.3)	53 (2.6)	1587 (12.4)

† Based on one-way ANOVA for age; χ² for all categorical variables.

ANOVA: Analysis of variance; APON: Aprepitant/fosaprepitant+ondansetron; APPA: Aprepitant/fosaprepitant+palonosetron; HEC: Highly emetogenic chemotherapy; MEC: Moderately emetogenic chemotherapy; NEPA: Netupitant/fosnetupitant+palonosetron.

Table 2. Mean chemotherapy induced nausea and vomiting related hospitalization cost by antiemetic regimen.

Cohort	Patients (n)	Mean cost ($)	p-value^†
NEPA	807	301	Reference
APON	2023	1006	<0.0001
APPA	12753	321	<0.0001

† Generalized linear model adjusted for age, sex, HEC/MEC and cancer type.

APON: Aprepitant/fosaprepitant+ondansetron; APPA: Aprepitant/fosaprepitant+palonosetron; HEC: Highly emetogenic chemotherapy; MEC: Moderately emetogenic chemotherapy; NEPA: Netupitant/fosnetupitant+palonosetron.

Table 3. Mean chemotherapy induced nausea and vomiting related hospitalization cost per hospitalized patient by antiemetic regimen.

Cohort	Chemotherapy	Patients (n)	Mean ($)	Median ($)
NEPA	HEC	36	5590	1193
APON	HEC	54	9740	7492
APPA	HEC	275	9960	7749
NEPA	MEC	7	5923	4649
APON	MEC	32	37988^†	53452
APPA	MEC	176	7666	5559

† Analysis excludes one outlier patient with a hospitalization cost of US$330,000.

APON: Aprepitant/fosaprepitant+ondansetron; APPA: Aprepitant/fosaprepitant+palonosetron; HEC: Highly emetogenic chemotherapy; MEC: Moderately emetogenic chemotherapy; NEPA: Netupitant/fosnetupitant+palonosetron.

Table 4. Chemotherapy induced nausea and vomiting related hospitalization and repeat hospitalizations by antiemetic regimen.

Hospital visits (n)	HEC										Patients with CINV related hospitalization (% of total patients)
	1	2	3	4	5	6	7	8	9	13
NEPA (n=583)	19	12	3	1	0	1	0	0	0	0	36 (6.2)
APON (n=1283)	36	14	0	3	1	0	0	0	0	0	54 (4.2)
APPA (n=8556)	132	101	11	23	4	3	1	0	0	0	275 (3.2)
Hospital visits (n)	MEC										Patients with CINV related hospitalization (% of total patients)
	1	2	3	4	5	6	7	8	9	13
NEPA (n=224)	4	3	0	0	0	0	0	0	0	0	7 (3.1)
APON (n=740)	23	9	0	0	0	0	0	0	0	0	32 (4.3)
APPA (n=4197)	66	78	7	16	2	1	3	1	1	1	176 (4.2)

APON: Aprepitant/fosaprepitant+ondansetron; APPA: Aprepitant/fosaprepitant+palonosetron; CINV: Chemotherapy induced nausea and vomiting; HEC: Highly emetogenic chemotherapy; MEC: Moderately emetogenic chemotherapy; NEPA: Netupitant/fosnetupitant+palonosetron.