OBJECTIVES: To investigate prescription patterns for setron antiemetics used alongside
chemotherapy in France, Germany, Italy, and the UK. METHODS: Prescription
data from June 2008 to July 2009 were extracted from the Synovate Oncology
Monitor, an ongoing database tracking prescriptions of anticancer therapies and
concomitant medications. Patients receiving setron prophylaxis (dolasetron, granisetron,
ondansetron, palonosetron, or tropisetron) with Moderately emetic chemotherapy
(MEC) or highly emetic chemotherapy (HEC) were selected. RESULTS: The
sample included 1715, 1658, 1830, and 1651 patients with MEC regimens in France,
Germany, Italy, and UK, respectively, and 557, 761, 903, and 627 patients with HEC
regimens. Ondansetron was used in 85.1%, 45.8%, 52.1%, and 83.3% of patients
with MEC regimens in France, Germany, Italy, and UK respectively, and 92.5%,
46.0%, 43.8%, and 62.2% of patients with HEC regimens. The shares of different
setrons were relatively similar between MEC and HEC regimens in Gemany. a stronger
association between setron and regimen category was found in other countries, with
different trends according to country. Doses of setrons were slightly higher for HEC
regimens than for MEC regimens in Italy, but substantially higher in other countries.
The average daily dose was found to increase with treatment duration in all countries.
Neurokinin 1 antagonists (NK1) were used alongside setron in up to 46% of patients
in Germany, depending on setron, but were very rarely used in Italy. CONCLUSIONS:
Utilization of setrons and concomitant medications (NK1, antipsychotics) varied
widely between European countries. It appears that German prescribers adapted the
dose of setron rather than the drug according to regimen category, contrary to Italian
prescribers. Such international comparisons may provide useful insight for improving
practice in different countries.