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The cost of chemotherapy-induced nausea and vomiting in Italy

The aim of this paper is to analyze the costs of chemotherapy-induced nausea and vomiting (CINV) in Italy.

In this prospective observational study at seven public oncology centers, incidence and intensity of CINV daily for 8 days after chemotherapy in consecutive patients receiving cisplatin-containing chemotherapy were recorded. All costs related to CINV (direct medical, direct nonmedical, and indirect) were recorded (in 2003 euros).

A total of 172 patients were enrolled; cost data were available for 168 patients. Thirty-seven percent of patients experienced acute CINV, and 57% experienced delayed CINV; 39% achieved total control, defined as no nausea, vomiting, or rescue therapy. Mean per-patient costs of acute and delayed CINV were €30.03 from the hospital perspective, €4.9 from the patient perspective, and €26.85 from the National Health Service (NHS) perspective. Costs of CINV were highly variable among oncology centers, largely because of differences in procedures for preventing delayed CINV. These costs were four times higher when antiemetic drugs were prescribed and paid for by the NHS than when antiemetic prophylaxis was provided directly from hospital pharmacies. Moreover, in the delayed phase, the NHS incurred a 94% increase in costs for patients without total control. Overall costs for patients who did not experience total control of CINV were €35.57 higher than for those who did (85% increase).

Costs of CINV for the Italian NHS could be reduced if hospitals furnished antiemetic prophylaxis directly to patients. Better control of both acute and delayed CINV would improve patient well-being as well as reduce the budgetary impact of CINV in Italy.

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Download references

The authors thank the Medical Oncology Division of Ferrara Hospital for enrolling patients in this study. Writing assistance was provided by Elizabeth V. Hillyer, with support from Merck & Co., Inc.

1. Medical Statistics Unit, Department of Internal Medicine and Public Health, University of L’Aquila, Via Pillino, 2, 63030, Spinetoli (AP), Italy

   Enzo Ballatori

2. Medical Oncology Division, Polyclinic Hospital, Perugia, Italy

   Fausto Roila & Stella Porrozzi

3. Department of Prevention, ZT 13, ASUR, Marche, Italy

   Benedetta Ruggeri

4. Division of Medical Oncology, Department of Oncology, S. Chiara University Hospital, Pisa, Italy

   Mauro Iannopollo

5. Division of Medical Oncology, Ospedale Civile, Sassari, Italy

   Giancarla Soru

6. Oncology Department, Ospedale Civile, Lugo di Ravenna, Italy

   Giorgio Cruciani

7. Medical Oncology, “G. Rummo” Hospital, Benevento, Italy

   Bruno Daniele

8. Department of Oncology, San Carlo Borromeo Hospital, Milan, Italy

   Maria Cristina Locatelli

9. Merck Research Laboratories, Health Economics, Blue Bell, PA, USA

   James Pellissier

10. Merck & Co. Inc., Outcomes Research, Whitehouse Station, NJ, USA

    Robert Deuson

1. Enzo Ballatori
2. Fausto Roila
3. Benedetta Ruggeri
4. Stella Porrozzi
5. Mauro Iannopollo
6. Giancarla Soru
7. Giorgio Cruciani
8. Bruno Daniele
9. Maria Cristina Locatelli
10. James Pellissier
11. Robert Deuson

Correspondence to Enzo Ballatori.

Ballatori, E., Roila, F., Ruggeri, B. et al. The cost of chemotherapy-induced nausea and vomiting in Italy. Support Care Cancer 15, 31–38 (2007). https://doi.org/10.1007/s00520-006-0094-x

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• Received: 15 January 2006

• Accepted: 17 May 2006

• Published: 21 June 2006

• Issue Date: January 2007

• DOI: https://doi.org/10.1007/s00520-006-0094-x

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