Search

Objective: Nausea and/or vomiting (N/V) are frequent side effects of opioid drugs. These are of major concerns to patients and caregivers and only few studies have focused on their economical costs., Design: This is a prospective, nonproduct-related, activity-based evaluation of personnel and material costs of opioid-related N/V among inpatients., Setting: Data were obtained from surgical, general medicine, and palliative care wards at 16 German hospitals of different size, healthcare mandate, and ownership., Patients, Participants: According to predefined criteria, of 462 documented N/V events, 340 were diagnosed as opioid related., Interventions: Elicited activities and pharmacological interventions for N/V episodes followed local standards., Main Outcome Measure: Both materials used and the time engaged to treat patients with N/V were documented on an "ad hoc" activity recording form. The total cost of an opioid-related N/V episode was calculated based on standard wages of the involved personnel and standard costs of the inherent materials used., Results: Mean staff tenure time for handling an episode of N/V was 26.2 ± 19.8 minutes (nausea 16.9 ± 28.7 minutes; nausea + vomiting: 33.4 ± 26.8 minutes). In the German context, this corresponds to average personnel costs of €18.06 ± 13.64. Material cost contributes to another €13.49 ±13.38 of costs mainly depending on acquisition costs of antiemetic drugs., Conclusions: N/V showed to have impact on workload of nurses and (to lesser extent) physicians and economic burden of €31 ± 22 for each N/V episode. In view of these results, the potential costs of strategies to minimize the incidence of N/V (use of antiemetics and/or the use of new analgesics) should be outweighed against the incurred costs of N/V.

Background: Cost containment measures in hospitals suspect the efficiency of 5-HT3-receptor antagonists (5-HT3-RA) in treating chemotherapy-induced emesis., Research: This paper compares the cost-efficacy of acute antiemetic interventions both for high and moderate emetogenic cancer treatments. The cost-efficacy-analysis is based on a recent metaanalysis comparing metoclopramide (MCP)- and 5-HT3-RA-containing antiemetic regimens both in comedication with corticosteroids. Total costs for treating moderate emetogenic cancer treatments sum up to DM 53.- for MCP-regimens and DM 55.- for 5-HT3-RA resp. In high emetogenic cancer treatments total costs for MCP-regimens are DM 76.- and DM 61.- for 5-HT3-RA. Total costs for fully controlled patients in moderate emetogenic cancer treatments are DM 77.- for MCP and DM 71.- for 5-HT3-RA. In high emetogenic cancer treatments costs for the fully controlled patient with MCP-regimens are DM 126.- and DM 79.- with 5-HT3-RA., Conclusion: Even under mere economical considerations 5-HT3-RAs should be prescribed in treating acute chemotherapy-induced emesis.