Medicine cost reduction effect  of adequate prophylactic administration of antiemetics

Abstract

The preventive administration of the antiemetics based on manifestation risk level of nausea and emesis in chemotherapy is considered to be effective. In the Nagara medical center （NMC）, necessity index of the administration of granisetron and the dose level of the dexamethasone were set loosely. Therefore Chemotherapy committee reviewed the usage of the antiemetic in accordance with the National Comprehensive Cancer Network （NCCN） guideline.

In chemotherapy regimen for the tumor of respiratory organs registered in NMC, the antiemetics in 14 regimens of the registered 22 regimen were amended. In the amended regimens, we compared the medicine cost of the antiemetics with the estimated cost without amendment. As a result, the medicine cost fell by 49.5% a year. In addition, for a lung cancer patient treated with the 3week-docetaxel treatment regimen that excluded granisetron with the change of the antiemetic, we compared incidence of nausea and emesis before and after the change over a 1-year period. As a result, the increase was not shown in the incidence of nausea and emesis by deletion of the granisetron.

By selecting antiemetic appropriately in accordance to the guideline, medicine costs fell without letting the incidence of nausea and emesis increase, and we were able to reduce the burden on the patient.