title: Costs of uncontrolled chemotherapy-induced nausea and vomiting among working-age cancer patients receiving highly or moderately emetogenic chemotherapy.
abstract: BACKGROUND
  Chemotherapy-induced nausea and vomiting (CINV) is among the most feared side effects of cancer treatment. Poorly controlled CINV may lead to additional office visits or emergency room admissions, thus increasing the overall costs of cancer care. The objective of the project was to estimate the societal costs of uncontrolled CINV among working-age cancer patients.
  
  
  METHODS
  The 1997-2002 Health and Productivity Management database, a proprietary database linking medical claims to work loss information, was used. The study population consisted of employees or their spouses who were cancer patients treated with highly or moderately emetogenic chemotherapy regimens. Costs of uncontrolled CINV were estimated by comparing the direct medical costs and indirect costs between those with and without uncontrolled CINV; all costs were normalized as monthly costs and updated to 2006 US dollars. The Wilcoxon Mann-Whitney test was used to compare the costs differences in univariate analyses, followed by multivariate analyses.
  
  
  RESULTS
  In all, 2,018 patients were identified; 1,771 (88%) received 5-HT(3) receptor antagonists, and uncontrolled CINV was found in 563 (28%). The estimated monthly medical costs associated with uncontrolled CINV were approximately 1,300 dollars higher for cancer patients at working ages. Subgroup analysis concluded that indirect costs per patient per month were 433 dollars higher for those in the uncontrolled CINV group.
  
  
  CONCLUSIONS
  Despite a prevalent use of the 5-HT(3) receptor antagonists, uncontrolled CINV remained a common and costly problem among cancer patients treated with highly or moderately emetogenic chemotherapy.
authors.affiliation: Section of Health Services Research, Department of Biostatistics, Division of Quantitative Sciences, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA. yashih@mdanderson.org
authors.forename: Ya-Chen
authors.initials: YC
authors.lastname: Tina Shih
authors.forename: Ying
authors.initials: Y
authors.lastname: Xu
authors.forename: Linda S
authors.initials: LS
authors.lastname: Elting
mesh_terms: D000932:Antiemetics / Q000191:economics / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000191:economics* / Q000517:prevention & control; D009369:Neoplasms / Q000188:drug therapy*; D019057:Quality-Adjusted Life Years; D014481:United States; D014839:Vomiting / Q000139:chemically induced / Q000191:economics* / Q000517:prevention & control
chemical_list: D000932:Antiemetics; D000970:Antineoplastic Agents