Interventions Are Needed to Prevent CINV-Related Hospitalizations

Chemotherapy-induced nausea and vomiting (CINV) is a common — and often costly — problem among patients with cancer.

In fact, according to a recent study presented at the 2017 Palliative and Supportive Care in Oncology Symposium, the average amount paid by insurers for each CINV-related hospitalization is more than $15,000.

Researchers examined 37,730 reports of hospitalization due to nausea and vomiting that occurred during 2014. The average amount that the hospital charged the insurance company was $26,603. Then, after adjustments, the average amount paid out was $11,232. With the additional costs of physicians’ professional fees, the total average costs ended up being $14,197, which, when taking inflation of the past few years into account, ends up being $15,120 in 2016.

Thankfully strides have been made to prevent nausea and vomiting incidents, but many patients still end up in the hospital.

“This economic impact, in addition to the consequences for patients’ quality of life, suggests the need for continued advances in preventing CINV and optimizing compliance with national antiemetic guidelines, particularly for chemotherapy with high emetogenic potential,” wrote the authors.

Further, Eric Roeland, M.D., author, medical oncologist and palliative care specialist at University of California San Diego Health, mentioned that healthcare organizations may not always follow proper protocol that could help decrease the risk of CINV.

“Surprisingly, the adherence to evidence-based guidelines is poor with approximately half of institutions not implementing the proper CINV prophylactic strategies,” he said. “Consequently, CINV is still a major concern for patients with cancer. If patients do not receive proper CINV prophylaxis [prevention], I would estimate that more than half of patients suffer from CINV. With the proper CINV prophylaxis, it is about 25 percent of patients who still have persistent symptoms of nausea and vomiting, especially in the breast cancer patient population.”

Roeland hopes that research will continue to advance in the field of CINV, particularly in assessing who is at a higher risk for the effect, as well as implementing and standardizing treatment protocols that can take people from having less nausea and vomiting to having none at all.

Gary Binder, another author on the study, Senior Director, HEOR and Value, also shared similar concerns.

“Further research is needed to identify the specific levels on compliance with guidelines and steps are needed to help streamline medical professionals’ ability to comply with the guidelines,” he said. “In addition, more monitoring of patient symptoms between office visits would help build awareness of the actual rate of CINV events, which would help avoid recurrence and hopefully reinforce the need for guideline compliance.”