Anti-vomiting drug can cut hospitalisation: Study

Routinely giving anti-vomiting drugs to children with gastroenteritis could prevent hospitalisation.

Washington: Routinely giving anti-vomiting drugs to children with gastroenteritis could prevent thousands of hospitalisations and save millions of dollars each year, a economic analysis has claimed.

Two years ago, a University of North Carolina (UNC) study had found that an anti-vomiting drug called ondansetron helps reduce vomiting, the need for intravenous fluids and hospital admissions in children with acute gastroenteritis.

Now, the new analysis carried out jointly by Canadian and UNC researchers found that routinely giving ondansetron to children with gastroenteritis-induced vomiting could help
prevent over 7,000 hospitalisations and save about USD 65 million a year in the US alone. The new study was published in the journal PLoS Medicine.

"This study is the first to demonstrate that in addition to being clinically beneficial, the administration of oral ondansetron to children... is economically advantageous," said lead researcher Stephen Freedman of University of Toronto.

Gastroenteritis is an infection, often caused by a virus, that causes vomiting and diarrhoea. It is popularly called "stomach flu" and is a very common ailment in children during the winter months.

Persistent vomiting from acute gastroenteritis can be very frightening to children and their families and also poses a risk of dehydration.

In many cases gastroenteritis in children can be managed effectively with oral fluids, including oral rehydration therapy, but some cases are severe enough to require hospital admission for intravenous fluids.

However, current practice guidelines do not recommend the use of ondansetron, in part because there was a lack of clear evidence that the treatment is cost effective.

To answer this question, the researchers used a type of statistical analysis, called decision tree analysis, to compare the costs of treatment in the hospital emergency department setting both with and without ondansetron.

Due to significant price differences between the US and Canada, they conducted a separate analysis for each country.

They concluded that giving ondansetron to eligible children in the US would prevent 29,246 intravenous insertions and 7,220 hospitalisations each year, with annual savings of USD 65.6 million to society and USD 61.1 million to payers of health care costs (including private insurance providers and Medicare).

In Canada, the study concluded that routine administration of ondansetron given routinely would prevent 4,065 intravenous insertions and 1,003 hospitalisations each year, with annual savings of 1.72 million Canadian dollars to society and 1.18 million Canadian dollars to payers of health care costs.

"In the past, people always thought that ondansetron was so expensive that its use `wasn`t worth it`," said Michael J Steiner, a UNC professor and co-author of the study.

"Our findings challenge that belief and may change clinician decision-making as well as practice guidelines."


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