Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshidakonoecho, Sakyo-ku, Kyoto, Japan 606-8501.
Support Care Cancer. 2012 Apr;20(4):813-20. doi: 10.1007/s00520-011-1155-3. Epub 2011 Apr 7.
The objective of this study was to estimate the cost of antiemetic therapy for chemotherapy-induced nausea and vomiting (CINV) in daily practice in Japan.
This was a retrospective observational study using medical records. Eligible patients were those with bladder or testicular cancer receiving platinum-containing highly emetogenic chemotherapy. The incidence of CINV on days 1-5 in single-day chemotherapy and on days 1-9 in multiple-day chemotherapy, and the costs of antiemetic therapy directly associated with the administration of antiemetics were estimated. The analysis of costs was performed from a hospital perspective.
A total of 54 patients or 169 chemotherapy courses were included. In all chemotherapy courses 5-HT(3) receptor antagonists were used on the day(s) that platinum-containing agents were administered and frequently used on subsequent days. In contrast, the use of corticosteroids was infrequent. Acute CINV in single-day chemotherapy was well controlled, but the incidences of delayed CINV in single-day chemotherapy and CINV in multiple-day chemotherapy were relatively high. The costs for antiemetic therapy were $484.65 in courses with CINV and $318.56 in courses without CINV, and the difference was approximately $170 per chemotherapy course, which was considered to be mainly imputable to the prevalence of CINV.
The cost of antiemetic therapy for CINV is substantial in Japan as well as in other countries, and it is suggested that the onset of CINV is a possible cost driver. The improvements in antiemetic therapy may contribute not only to improved patient well-being but also to a reduction of economic burden.
本研究旨在评估日本临床实践中化疗引起的恶心和呕吐（CINV）止吐治疗的成本。
这是一项使用病历的回顾性观察性研究。合格患者为接受含铂高致吐性化疗的膀胱癌或睾丸癌患者。评估了单天化疗第 1-5 天和多日化疗第 1-9 天 CINV 的发生率，以及与止吐剂给药直接相关的止吐治疗成本。成本分析采用医院视角。
共纳入 54 例患者或 169 个化疗疗程。所有化疗疗程中，5-HT3 受体拮抗剂在含铂药物给药日使用，并在随后的几天中频繁使用。相比之下，皮质类固醇的使用频率较低。单天化疗的急性 CINV 得到了很好的控制，但单天化疗和多日化疗的迟发性 CINV 发生率相对较高。有 CINV 的化疗疗程的止吐治疗费用为 484.65 美元，无 CINV 的化疗疗程的止吐治疗费用为 318.56 美元，每个化疗疗程的差异约为 170 美元，这主要归因于 CINV 的发生率。
CINV 的止吐治疗成本在日本与其他国家一样巨大，提示 CINV 的发生可能是一个成本驱动因素。止吐治疗的改善不仅有助于提高患者的生活质量，还可能减轻经济负担。
