Cost-effectiveness of antiemetics use during cancer chemotherapy

Emesis is a major obstacle to cancer chemotherapy. Patients indicate that nausea and vomiting are a substantial concern when receiving chemotherapy. In recent years, newer antiemetics, serotonin antagonists, have been commercialized. Other agents, particularly the neurokin-1 antagonists, are in clinical development and should be available in the near future. Treatment of chemotherapy-induced nausea and vomiting has recently been reviewed by Gralla and Hesketh. The serotonin antagonists currently available are dolasetron (Anzemet), Ben Venue Laboratories, OH, USA), granisetron, ondansetron and tropisetron. They are characterized by an improved efficacy when compared with traditional metoclopramide-based antiemetic regimens. They are particularly effective for the control of acute emesis (within the first 24-h following chemotherapy). Their efficacy for the control of delayed emesis is less impressive and has been shown to be comparable with conventional antiemetics, such as dexamethasone. The serotonin antagonists are also associated with a higher acquisition cost than traditional antiemetics. This has aroused an interest in studying the economic impact of emesis and its treatment. Many economic evaluations have been undertaken since the introduction of the serotonin antagonists.