PMID- 35261710
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220310
IS  - 1942-2962 (Print)
IS  - 1942-2970 (Electronic)
IS  - 1942-2962 (Linking)
VI  - 14
IP  - 3
DP  - 2021 Sep
TI  - Granisetron Extended-Release Subcutaneous Injection versus Palonosetron Infusion 
      for CINV Prevention: Cost Comparison of Unscheduled Hydration.
PG  - 1-7
AB  - BACKGROUND: Granisetron extended-release subcutaneous (SC) injection is a novel 
      formulation of granisetron for the prevention of acute and delayed 
      chemotherapy-induced nausea and vomiting (CINV). Palonosetron is administered 
      intravenously and is indicated for CINV prevention in acute and delayed phases 
      after the use of moderately emetogenic chemotherapy (MEC) and in the acute phase 
      after highly emetogenic chemotherapy (HEC). No data are available regarding the 
      impact of SC granisetron on the cost of unscheduled hydration compared with other 
      antiemetic drugs, specifically the older-generation palonosetron. OBJECTIVE: To 
      compare the costs of unscheduled hydration associated with breakthrough CINV 
      after SC granisetron versus palonosetron administration in patients receiving MEC 
      or HEC. METHODS: This retrospective analysis was based on electronic medical 
      records data from a single multicenter, community-based practice involving 
      patients receiving MEC or HEC with a 3-drug antiemetic regimen, including a 
      neurokinin-1 receptor antagonist, dexamethasone, and either SC granisetron or 
      palonosetron. A cost-of-care analysis for SC granisetron and palonosetron was 
      based on the maximum per-unit Medicare reimbursement amounts for the use of 
      unscheduled hydration, administration of rescue antiemetic drugs, laboratory 
      tests, and patient office evaluations. RESULTS: A total of 182 patient records 
      were evaluated, 91 for patients receiving SC granisetron and 91 receiving 
      palonosetron. The mean per-patient cost of care related to unscheduled hydration 
      in patients receiving HEC or MEC was significantly lower with SC granisetron 
      ($296) than palonosetron ($837; P <.0001), including subset analysis of patients 
      requiring additional care (SC granisetron [$691], N = 39; palonosetron [$1058], N 
      = 72; P = .0260). The mean hydration costs per patient receiving HEC or MEC were 
      lower with SC granisetron ($62) than with palonosetron ($253; P <.0001). The 
      hydration costs per patient receiving only HEC were lower with SC granisetron 
      ($66) than palonosetron ($280; P <.0001). The per-patient costs were lower when 
      SC granisetron was administered than when palonosetron was administered as part 
      of the antiemetic regimen, except for the cost of rescue antiemetic drug in 
      patients receiving MEC. Fewer median unscheduled hydration therapies per patient 
      were used with SC granisetron versus palonosetron (HEC, 3 vs 5; MEC, 2 vs 3). 
      CONCLUSION: The use of SC granisetron reduced the total per-patient costs of care 
      associated with unscheduled hydration compared with palonosetron in patients 
      receiving HEC or MEC for breakthrough CINV events.
CI  - Copyright (c) 2021 by Engage Healthcare Communications, LLC.
FAU - Barnes, Martin
AU  - Barnes M
AD  - Internal Medicine Resident, PGY3, John T. Mather Memorial Hospital, Port 
      Jefferson, NY.
FAU - Calcanes, George
AU  - Calcanes G
AD  - Chief Clinical Officer, New York Cancer & Blood Specialists, Port Jefferson 
      Station, NY.
FAU - Mosier, Michael C
AU  - Mosier MC
AD  - Director of Biostatistics, EMB Statistical Solutions, Overland Park, KS.
FAU - Vacirca, Jeffrey
AU  - Vacirca J
AD  - Chief Executive Officer, New York Cancer & Blood Specialists.
FAU - Malik, Zulfiqar
AU  - Malik Z
AD  - Chief of Research, New York Cancer & Blood Specialists.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Health Drug Benefits
JT  - American health & drug benefits
JID - 101479877
PMC - PMC8845525
OTO - NOTNLM
OT  - HEC
OT  - MEC
OT  - antiemetic regimen
OT  - breakthrough CINV
OT  - hydration costs
OT  - palonosetron
OT  - subcutaneous granisetron extended-release
EDAT- 2022/03/10 06:00
MHDA- 2022/03/10 06:01
PMCR- 2021/09/01
CRDT- 2022/03/09 08:44
PHST- 2020/09/22 00:00 [received]
PHST- 2021/02/17 00:00 [accepted]
PHST- 2022/03/09 08:44 [entrez]
PHST- 2022/03/10 06:00 [pubmed]
PHST- 2022/03/10 06:01 [medline]
PHST- 2021/09/01 00:00 [pmc-release]
PST - ppublish
SO  - Am Health Drug Benefits. 2021 Sep;14(3):1-7.