HPE CINV Pocket Guide 2018 | Page 46

table 1 Cost of CINV and perspective of analysis Cost Perspective Direct healthcare cost reimbursed/ covered by insurance Society Hospitalisation due to CINV episode Healthcare services delivered for antiemetic treatment Cost of healthcare professional administering antiemetic treatment Payer (insurance/government) Antiemetic drugs (only those reimbursed/covered) Individual patient Antiemetic drugs (only those not reimbursed/covered) Adapted from reference 10 sectors, at the individual level, or if they concern losses of productivity, emphasises who is sustaining the cost of treating and managing the disease. 12 Normally, the perspective adopted in these economic studies is the societal one. This is because the costs incurred to treat CINV can be borne by several subjects (for example, patients, family) in addition to the National Health Service. Having said that, it often happens that narrower perspectives are considered and in these cases the cost categories to be included in the analysis can differ. Table 1 provides further details on the type of costs included for each perspective. 46 | 2018 | hospitalpharmacyeurope.com Most studies focus on the direct healthcare costs of CINV, whereas fewer attempts have been made to estimate non-healthcare direct costs and productivity losses. In general, estimates vary greatly depending on the heterogeneity of study design and perspectives. However, in all cases analysed, studies agree that failure to effectively treat CINV leads to an increase in costs of cancer care. Turini et al calculated costs for the treatment of severe episodes of CINV for patients in Italy, France and Germany. 13 An online survey addressed to oncologists and oncology nurses was performed. The survey included 41 questions about the management and the