Nakamura A, et al. – The administration of aprepitant was explored regarding clinical and cost benefits for the prophylaxis of chemotherapy–induced nausea and vomiting (CINV) during high–dose chemotherapy (HDCT). This study noticed the reduction in the incidence of severe nausea after the addition of aprepitant for CINV prophylaxis during HDCT. It seemed to offer economic benefit in the overall management of HDCT prior to autologous peripheral blood stem cell transplantation.

Methods

• The charts of patients who received HDCT at the institution between January 2009 and December 2013, had been retrospectively reviewed.
• Direct medical costs were employed to appraise cost-effectiveness.

Results

• 38 patients were delineated (27 with non-Hodgkin lymphoma and 11 with multiple myeloma).
• Aprepitant and granisetron (aprepitant group) were administered to thirteen patients for CINV prophylaxis.
• On the other hand, 25 patients received granisetron only (non-aprepitant group).
• Results revealed significantly lower incidence of severe nausea (≥grade 3) in the aprepitant group than in the non-aprepitant group (p = 0.039).
• In the aprepitant group, the total mean cost per patient during hospitalization, excluding the cost of HDCT and transplantation, was USD 10,941.8, and USD 14,577.2 in the non-aprepitant group (p= 0.041).
• In addition, this cost benefit reflected reductions in the costs of hospitalization, transfusion, and infection treatment.