Financial performance incentives may be useful for reducing overspending on antiemetic drugs for patients undergoing chemotherapy, according to an article published in JAMA Oncology.1

Antiemetic drugs help prevent nausea and vomiting among patients undergoing chemotherapy. In 2013, the American Society for Clinical Oncology (ASCO) recommended that oncologists not overuse these drugs, which can be very expensive. For the present study, researchers evaluated whether physicians are adhering to ASCO’s guidelines.

For almost a quarter of the 678,220 patients included in the study, antiemetic drugs were overused (defined by comparing drug use to risk of nausea from a chemotherapy regimen). Overuse of antiemetic drugs, overall, has not changed drastically since the 2013 ASCO guidelines were published.

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The authors conclude that voluntary reduction in the overuse of antiemetic drugs is not sufficient for uniform practice of the 2013 ASCO guidelines. Other incentives may be necessary to reduce this overuse, in an effort to lower the ever-increasing cost of cancer care in the United States.

Study limitations, such as inability to accurately measure all chemotherapy doses, may have influenced these results.


  1. Encinosa W, Davidoff AJ. Changes in antiemetic overuse in response to choosing wisely recommendations. JAMA Oncol. 2016 Sep 15. doi: 10.1001/jamaoncol.2016.2530 [Epub ahead of print]