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The studies varied in designs, patients, 5-HT3RA regimens, and the definition of outcomes. The US studies reported higher drug costs for CINV prophylaxis with palonosetron compared with ondansetron, lower medical outpatient and inpatient costs for palonosetron versus other 5-HT3RAs, and higher acquisition costs for palonosetron versus ondansetron or other 5-HT3RAs. Fewer patients receiving palonosetron versus with ondansetron or other 5-HT3RAs required rescue medication or used outpatient or inpatient care. In Europe and in Canada, the total pharmacy costs and use of rescue medications reported were lower for patients receiving prophylaxis with palonosetron. They stated that the use of palonosetron as a standard treatment may lead to reduced service utilization for CINV. Zhou and co-workers discussed existing and emerging therapeutic options, and examined studies focusing on palonosetron with regards to efficacy, pharmacology, tolerability, safety, and patient-derived outcomes.
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