Cost-reducing treatment algorithms for antineoplastic drug-induced nausea and vomiting

Area of Science:

• Oncology
• Pharmacology
• Health Economics

Background:

• Chemotherapy-induced nausea and vomiting (CINV) poses a significant challenge in cancer care, impacting patient quality of life and treatment adherence.
• Antiemetic therapy costs can be substantial, necessitating strategies for cost reduction and optimized drug utilization.

Purpose of the Study:

• To develop and implement a cost-saving treatment algorithm and preprinted order form for managing CINV in patients receiving antineoplastic therapy.
• To evaluate the impact of the algorithm on antiemetic therapy costs and patient outcomes.

Main Methods:

• A multidisciplinary team (pharmacists, oncologists, nurses) designed an algorithm focusing on matching therapy to emetogenic potential, dose reduction, oral route preference, and alternative delayed-onset CINV management.
• The algorithm was integrated into physician order forms for adult and pediatric patients.
• Outcome data and prescription patterns were compared before and after implementation.

Main Results:

• Patient outcomes remained comparable or improved after guideline implementation.
• Over 85% compliance with the algorithm was observed more than a year post-implementation.
• Nearly $205,000 in cost avoidance was achieved in the first year.

Conclusions:

• An integrated antiemetic treatment algorithm and physician order form effectively reduced therapy expenses.
• Early collaboration with oncologists was crucial for successful implementation and acceptance.
• The strategy demonstrated significant cost savings while maintaining or improving patient care quality for CINV.