Presented By:
Julie Hoffman, ADN, RN, OCN
Sylvia Wentzky, ADN, RN
Bon Secours St. Francis Health System
Greenville, South Carolina
The purpose of this Evidence Based Project
was to compare the cost effectiveness of
two anti-nausea medications: ALOXI and
ZOFRAN for patients receiving highly
emetogenic chemotherapy regimens, such
as Cisplatin.




Bon Secours St. Francis Health System
Outpatient Infusion Center
Retrospective 3 month chart review
Solid tumor types
100 adult patients





Gender
Age
Diagnosis
Types of Lung Cancer Treatments
Antiemetics in Cisplatin Protocols
Aloxi:
 IV push 1 dose day
of chemo
 Nursing time 5 minutes
 Supplies – needle &
syringe
Zofran:
 IVPB treatment day
 2 extra days of IV
fluids and daily
Zofran IVPB
 Nursing time –
6.5 hours
 Supplies – IV tubing
ALOXI8% Total Cost Savings
Increased Patient
Satisfaction
Decreased Nursing Time
ZOFRANLower Patient
Satisfaction
Increased Clinic Visits
Increased Nursing Time



The cost analysis demonstrated that
selecting Aloxi on Day 1 of the
chemotherapy treatment impacted:
Cost
Patient Satisfaction
Nurse Time
Limitations of this study included a small
sample size, retrospective nature, and
selective diagnosis of Lung Cancer.




Product Availability
Provider Changes & Preferences
Protocol Changes
◦ Dexamethasone 10 mg IVP
◦ Zofran 8 mg IVP
◦ Emend 150 mg IVPB
3 Month Retrospective Analysis (2014)
◦ 12 Lung Cancer Patients – Cisplatin
Treatment
◦ 1 Patient Needed Hydration
DeLeon, A. (2006, October). Palonosetron (Aloxi): A Second
Generation 5HT3 Receptor Antagonist for Chemotherapy-Induced
Nausea and Vomiting. Baylor University Medical Center Proceeding,
19(4),413-416. Retrieved from
http:///www.medscapecom/viewarticle/512796
Feinberg, B.A., Gilmore, J., Haislip, S., Gondesen, T., Saleh, N., Lenz,
W. (2009, February). Data-Driven Medical Decision-Making in
Managing Chemotherapy-Induced Nausea and Vomiting, Community
Oncology, 62-67. Retrieved from http://www.CommunityOncology.net
National Comprehensive Cancer Network. (2011). NCCN Clinical
Practice Guilelines in Oncology (NCCN Guidelines) Antiemesis
(Version 1.2012). Fort Washington, PA: Ettinger, David S., et al.
Tarricone, R., & Girolami, F. (2005). Economic Evaluation of a New
Antiemetic Drug – Palonosetron Versus Ondansetron, Clinical Drug
Investiation, 25 (9), 597-608 Retrieved from
http://www.nci.nlm.nih.gov/pmc/articles/PMC1618755
Bon Secours St. Francis Health System
Outpatient Infusion Center
Greenville, South Carolina
JULIE HOFFMAN, ADN, RN, OCN
JULIANA_HOFFMAN @BSHSI.ORG
SYLVIA WENTZKY, ADN, RN
SYLVIA_WENTZKY@BSHSI.ORG
TRACY FASOLINO, PhD, FNP, ACHPN
TRACY_FASOLINO@BSHSI.ORG