Impact on daily functioning and indirect/direct costs associated with chemotherapy-induced nausea and vomiting (CINV) in a U.S. population.
OBJECTIVE
Chemotherapy-induced nausea and vomiting (CINV) is a debilitating side effect of chemotherapy, but it may be prevented or mitigated with medications. Uncontrolled CINV can lead to reduced quality of life and can result in increased costs (due to health care utilization and missed work). We prospectively assessed the prevalence and burden of CINV in a US population.


METHODS
Final analysis was performed on 178 patients, beginning chemotherapy during 2007-2008 at oncology specialty settings. Patients kept a diary recording use of antiemetic medications just before the start of chemotherapy and use of antiemetic medications, health care resources, and episodes of nausea and vomiting during the 5 days following. In addition, they completed a Functional Living Index-Emesis (FLIE) questionnaire and a Work Productivity and Assessment Inventory-Nausea and Vomiting assessment, to determine the impact of CINV on daily functioning and on work productivity, respectively. Physicians independently recorded prescribed medications and health care utilization.


RESULTS
Of the patients, 61.2% reported experiencing CINV (34.3% with acute CINV and 58.4% with delayed CINV). Based on the FLIE assessment, 37.2% of all patients reported reduced daily functioning, and of those with poorly managed CINV, about 90% reported a significant impact on daily functioning. Total costs due to CINV were on average $778.58 per patient from the day of administration through the 5 days following the first cycle of chemotherapy; patients with more severe CINV typically had higher costs.


CONCLUSIONS
CINV remains a significant problem among US patients, suggesting a need for more effective prophylaxis use in clinical practice.
Haiderali
Amin
A
Global Health Outcomes-Oncology, GlaxoSmithKline, 1250 South Collegeville Road, Mail Code UP4110, Collegeville, PA 19426, USA.
Menditto
Laura
L
Good
Margaret
M
Teitelbaum
April
A
Wegner
Jessica
J
D000328:Adult; D000368:Aged; D000932:Antiemetics / Q000191:economics / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000191:economics / Q000627:therapeutic use; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000191:economics / Q000517:prevention & control / Q000523:psychology*; D009369:Neoplasms / Q000188:drug therapy; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014839:Vomiting / Q000139:chemically induced / Q000191:economics / Q000517:prevention & control / Q000523:psychology*
D000932:Antiemetics; D000970:Antineoplastic Agents